A client recently had a myocardial infarction. Which medication would the nurse anticipate the provider prescribing?
Polyethylene Glycol
Bisacodyl
Senna
Docusate Sodium
The Correct Answer is D
A) Polyethylene Glycol: Polyethylene glycol is a medication typically used to treat constipation by promoting bowel movements. While it can be useful in managing constipation, it is not commonly prescribed after a myocardial infarction. In this situation, the focus is more on medications that promote heart health, reduce cardiac workload, and prevent complications related to the heart attack.
B) Bisacodyl: Bisacodyl is a stimulant laxative used to relieve constipation. However, this medication is not typically prescribed immediately following a myocardial infarction. Stimulant laxatives can cause dehydration and excessive fluid shifts, which can be harmful to a client recovering from a heart attack. The focus would be on safer options for bowel management in this context.
C) Senna: Senna is also a stimulant laxative, used for relieving constipation. Similar to bisacodyl, it is not ideal for clients who have recently experienced a myocardial infarction due to its potential for causing dehydration and electrolyte imbalances, which could negatively affect heart function. A gentler approach to bowel management is preferred for these clients.
D) Docusate Sodium: Docusate sodium is a stool softener commonly prescribed to prevent constipation, especially in clients who have recently had a myocardial infarction. After a heart attack, it's important to avoid straining during bowel movements, as this could increase pressure on the heart. Docusate sodium helps soften stools and promotes smoother bowel movements without stimulating the gastrointestinal system in a way that would elevate cardiac stress. It is the most appropriate choice for this client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) "I know it is really busy but I do not have time to help you either. I have my own clients.": While it may be tempting to express frustration due to being busy, this response lacks professionalism and does not address the situation appropriately. As healthcare professionals, it is important to communicate effectively and collaborate with colleagues to ensure safe patient care, even when busy. Instead, the nurse should express the need to follow protocols while offering help in a safe manner.
B) "Are you sure the doctor ordered that much morphine? It seems like a lot to give all at once.": Although questioning the dosage is part of safe nursing practice, this response is unnecessary in this situation. If there is a concern about the prescribed amount of morphine, it should be verified with the healthcare provider. However, this question does not directly address the issue of administering the medication safely. It also does not ensure that the nurse is following correct protocols for preparing and administering medication.
C) "I can give your client their pain medications, but I need to draw up and prepare it myself.": This response is the most appropriate because it ensures the nurse is adhering to safe medication administration practices. The nurse should always prepare and administer medications themselves to verify the correct dosage, route, and patient. Allowing another nurse to prepare medication and administering it without proper verification can lead to medication errors. This response also shows willingness to help while maintaining safety standards.
D) "Sure thing, give me that syringe and I will give it for you while you are on break.": This response is inappropriate because it involves accepting medication from another nurse without verifying that the correct drug, dose, and preparation have been followed. It is unsafe to administer medications prepared by others without reviewing the medication and ensuring that everything is accurate. Nurses must always prepare and administer their own medications to prevent potential medication errors.
Correct Answer is A
Explanation
To determine if the client's dose is safe and therapeutic, we need to calculate the appropriate dosing range based on the client's weight and compare it with the ordered dose.
Client's weight: 45 kg
Ordered dose: 500 mg every 8 hours, which equals 1500 mg/day (500 mg × 3 doses).
Calculate the therapeutic range:
The dosing range in the Davis Drug Guide is 20 to 40 mg/kg/day. So, for this client, based on their weight of 45 kg:
Minimum dose: 20 mg × 45 kg = 900 mg/day
Maximum dose: 40 mg × 45 kg = 1800 mg/day
The ordered dose of 1500 mg/day falls within this range (900 mg/day to 1800 mg/day), which means it is safe and therapeutic for the client.
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