A client on a morphine PCA pump is noted to be drowsy and lethargic with pinpoint pupils and the following vitals: pulse 84 beats/minute, respiratory rate 10 breaths/minute, blood pressure 90/50 mm Hg. What is the nurse's best action?

Discuss possible opiate dependence with the client's provider.

Note the effectiveness of the analgesia in the client's chart.

Encourage the client to turn over, and cough and take deep breaths.

Prepare to administer naloxone and provide respiratory support.

Answer and Explanation

The Correct Answer is D

a) While discussing possible opiate dependence is important, the immediate concern is the client's respiratory depression and altered level of consciousness, which may require naloxone administration.

b) Noting the effectiveness of analgesia is relevant but does not address the current respiratory depression and lethargy observed in the client.

c) Encouraging the client to turn over and cough may not be effective in addressing severe respiratory depression, and immediate intervention is needed.

d) The client's symptoms, including drowsiness, lethargy, pinpoint pupils, and respiratory depression, are consistent with opioid overdose. Naloxone is the antidote for opioid toxicity and should be administered promptly.

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Correct Answer is B

Explanation

A) While beta-blockers can mask some symptoms of hypoglycemia, the major concern in this scenario is ketoacidosis.

B) Beta-blockers, like propranolol, can mask the typical symptoms of hypoglycemia (tachycardia, palpitations), leading to a delayed recognition of low blood sugar levels.

C) Propranolol may enhance the hypoglycemic effect of insulin, but the primary concern in this case is ketoacidosis.

D) Beta-blockers can indeed cause insulin resistance, but the primary concern in this context is the risk of ketoacidosis.

A. Antibiotic resistance B. Renal disease C. Liver disease D. Interpatient variation

Correct Answer is B

Explanation

A) Antibiotic resistance is not a reason to adjust the dose of gentamicin.

B) Gentamicin is primarily excreted by the kidneys. In the presence of renal disease, the dose may need to be adjusted to prevent toxicity.

C) Liver disease does not directly impact the metabolism or excretion of gentamicin, so it is not typically a factor in dose adjustment.

D) Interpatient variation alone may not prompt a specific dose adjustment; individual patient factors, especially renal function, are crucial in determining gentamicin dosage.

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A client on a morphine PCA pump is noted to be drowsy and lethargic with pinpoint pupils and the following vitals: pulse 84 beats/minute, respiratory rate 10 breaths/minute, blood pressure 90/50 mm Hg. What is the nurse's best action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

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