A client has suffered a partial thickness second-degree burn injury of the chest, abdomen, and upper legs and is scheduled for hydrotherapy and debridement.
Which of these actions should the nurse take to effectively assist the patient?
Medicate the client 30 minutes before the procedure.
Reassure the client that the procedure is not painful.
Utilize meditation and imagery.
Administer pain medication around the clock.
The Correct Answer is A
Choice A rationale
Medicate the client 30 minutes before the procedure. This is the correct action. Administering pain medication 30 minutes before the procedure allows the medication to take effect and provides pain control during the procedure.
Choice B rationale
Reassure the client that the procedure is not painful. This is not accurate. Debridement and hydrotherapy can be painful, so it’s important to manage the client’s pain effectively.
Choice C rationale
Utilize meditation and imagery. While these techniques can be helpful adjuncts to pain management, they should not replace pharmacological pain management in this situation.
Choice D rationale
Administer pain medication around the clock. While it’s important to manage pain effectively, this does not specifically address the client’s needs during the hydrotherapy and debridement procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Sorbitol is a type of sugar alcohol used as a sweetener in many diet foods. It is also used in certain medications as a laxative to relieve constipation. However, it is not typically associated with liver failure and would not likely be questioned by the nurse in this context.
Choice B rationale
Lactulose is a type of sugar that is broken down in the large intestine into mild acids that draw water into the intestine, which then helps soften the stools. It is often used to treat constipation and is also used to reduce high blood ammonia levels in patients with liver disease. It would not typically be questioned by the nurse for a patient with chronic liver failure.
Choice C rationale
Neomycin is an antibiotic that is used to reduce the amount of ammonia produced by bacteria in the intestines. High levels of ammonia can cause hepatic encephalopathy, a serious complication of liver disease. Therefore, neomycin can be beneficial for patients with chronic liver failure and would not likely be questioned by the nurse.
Choice D rationale
Acetaminophen, also known as paracetamol, is a common over-the-counter medication used to relieve pain and reduce fever. However, high doses or long-term use of acetaminophen can cause liver damage. In fact, acetaminophen overdose is a common cause of acute liver failure. Therefore, the nurse should question an order for acetaminophen for a patient with chronic liver failure.
Correct Answer is C
Explanation
Choice A rationale
A DNR prescription does not mean that the patient will only receive pain medication for their treatments. A DNR order simply means that if the patient’s heart stops beating or they stop breathing, medical staff will not attempt resuscitation3.
Choice B rationale
A DNR prescription does not necessarily limit a patient’s current treatment regimen. It only specifies that CPR will not be performed in the event of cardiac or respiratory arrest. Other treatments can still be provided based on the patient’s wishes and the medical team’s recommendations3.
Choice C rationale
A DNR prescription allows a patient to continue with their current treatment regimen. The DNR order only comes into effect if the patient’s heart stops or they stop breathing3.
Choice D rationale
While a DNR prescription may limit the ability to receive invasive procedures in the event of cardiac or respiratory arrest, it does not limit other forms of treatment. The patient can still receive treatments that align with their goals of care3.
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