A client with diabetes has returned from the post-anesthesia care unit (PACU) after a below-the-knee amputation (BKA) of the left leg.
Which physician’s order should the nurse implement?
Administer morphine 2-4 mg IV prn for pain.
Apply a figure of 8 pressure dressing starting day two post-operatively.
Administer antibiotics as prescribed.
Apply ice to the stump for 60-90 minutes.
The Correct Answer is A
The correct answer is Choice A. After a below-the-knee amputation (BKA), pain management is crucial. Administering morphine 2-4 mg IV prn for pain is an appropriate physician’s order to implement. Pain can be severe after amputation, and effective pain management can improve patient comfort, reduce anxiety, and aid in recovery. Applying a figure of 8 pressure dressing starting day two post-operatively (Choice B) is not typically done after a BKA7. The operative dressing and splint should be maintained, and the wound should be kept clean, dry, and intact. Administering antibiotics as prescribed (Choice C) is important, but it is not the first action to take. Pain management is the priority immediately after surgery. Applying ice to the stump for 60-90 minutes (Choice D) is not typically done after a BKA7. The operative dressing and splint should be maintained, and the wound should be kept clean, dry, and intact.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While understanding the recommended diabetic diet is important for managing type 1 diabetes, it is not the immediate priority for a client who has received no instruction on diabetes management. Without insulin, a person with type 1 diabetes can develop life- threatening diabetic ketoacidosis, regardless of their diet.
Choice B rationale
Administration of insulin is the immediate priority for a client newly diagnosed with type 1 diabetes. In type 1 diabetes, the body does not produce insulin, a hormone that regulates blood sugar levels. Without insulin, blood sugar levels can become dangerously high, leading to diabetic ketoacidosis, a serious condition that requires emergency medical treatment.
Choice C rationale
While exercise is an important part of managing diabetes, it is not the immediate priority for a client newly diagnosed with type 1 diabetes who has received no instruction on diabetes management. Exercise can help regulate blood sugar levels, but without insulin, exercise alone is not sufficient to prevent diabetic ketoacidosis.
Choice D rationale
Urine testing for ketones is an important part of managing type 1 diabetes, especially during illness or stress, when ketone levels can rise quickly. However, it is not the immediate priority for a client newly diagnosed with type 1 diabetes who has received no instruction on diabetes management.
Correct Answer is B
Explanation
Choice A rationale
Increasing the nighttime insulin glargine dose may exacerbate the Somogyi effect, a phenomenon where the blood sugar level drops too low overnight, causing a rebound high blood sugar level in the morning.
Choice B rationale
Consuming a snack at bedtime can help prevent the blood sugar level from dropping too low overnight, thus preventing the Somogyi effect.
Choice C rationale
Checking the morning cortisol level is not directly related to managing the Somogyi effect.
Choice D rationale
Checking the glucose level at 2 a.m. and 8 a.m. can help identify the Somogyi effect, but it does not prevent it.
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