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A nurse in the emergency department (ED) is caring for an older adult client.

Exhibits

Which of the following prescriptions from the provider should the nurse anticipate? Select all that apply.

Obtain a serum WBC count.

Insert indwelling urinary catheter.

Make the client NPO.

Initiate antibiotic therapy.

Obtain a consent for surgery.

Withhold metoprolol.

Administer acetaminophen.

Collect urine for urinalysis and culture and sensitivity.

Obtain chest x-ray.

Answer and Explanation

Correct Answer : A,D,G,H

A. Obtain a serum WBC count: A WBC count will help assess for infection, as the client presents with fever, confusion, and urinary symptoms. Elevated WBC could suggest a urinary tract infection (UTI) or other infection.
B. Insert indwelling urinary catheter: An indwelling catheter is not immediately necessary unless the client is unable to void or requires continuous monitoring. Non-invasive methods like obtaining a urine sample for analysis would be a priority.
C. Make the client NPO: There is no indication that the client requires NPO status at this time. Unless surgery or another procedure is planned, this is not necessary.
D. Initiate antibiotic therapy: Given the client's symptoms (fever, confusion, urinary frequency, urgency, and dark urine), a UTI or other infection is likely. Antibiotics are needed to treat the suspected infection.
E. Obtain a consent for surgery: There is no indication that surgery is needed based on the current clinical information. The primary concern is infection, not surgical intervention.
F. Withhold metoprolol: While metoprolol may lower blood pressure, there is no indication to withhold it at this time. The client’s blood pressure is already low, and withholding this medication could worsen hypotension. Any changes in the medication regimen should be made based on further evaluation by the provider.
G. Administer acetaminophen: Acetaminophen is indicated to help reduce the client's fever (39.3°C/102.7°F). Managing the fever will help improve comfort and prevent complications like delirium.
H. Collect urine for urinalysis and culture and sensitivity: Urine analysis and culture will help confirm the presence of a UTI, identify the causative pathogen, and guide appropriate antibiotic therapy.
I. Obtain chest x-ray: A chest x-ray is not necessary unless there is a suspicion of a respiratory infection, such as pneumonia. The symptoms are more consistent with a UTI or systemic infection, so a chest x-ray is not a priority.

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Correct Answer is ["A","C"]

Explanation

A. Caffeine is a stimulant and can interfere with sleep, especially if consumed in the afternoon or evening. It can lead to difficulty falling asleep and disrupt the sleep cycle.
B. While heavy meals close to bedtime can cause discomfort or indigestion, a light evening meal generally does not significantly interfere with sleep for most individuals.
C. The use of electronic devices, particularly before bedtime, can interfere with sleep due to the blue light emitted by screens. This light can suppress the production of melatonin, a hormone that helps regulate sleep.
D. Regular exercise generally promotes better sleep. However, vigorous exercise close to bedtime may interfere with sleep due to the increase in adrenaline, but this is not always the case.
E. The medications taken by the individual do not interfere with sleep.

A. "I had to retire because my boss didn't like me." B. "There were lay-offs at my company, so I journaled about what I accomplished during my career." C. "I'm so glad I've retired because the work was making me sick and depressed." D. "Since I retired, I have entered many gardening competitions."

Correct Answer is D

Explanation

A. "I had to retire because my boss didn't like me.": Indicates projection, attributing personal feelings to someone else.

B. "There were lay-offs at my company, so I journaled about what I accomplished during my career.": Indicates positive coping, not compensation.

C. "I'm so glad I've retired because the work was making me sick and depressed.": Indicates rationalization, justifying the situation.

D. "Since I retired, I have entered many gardening competitions.": The client is compensating for the loss of work-related identity by engaging in competitive gardening, a constructive coping strategy.

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A nurse in the emergency department (ED) is caring for an older adult client. Exhibits Which of the following prescriptions from the provider should the nurse anticipate? Select all that apply.

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A nurse in the emergency department (ED) is caring for an older adult client.

Exhibits

Which of the following prescriptions from the provider should the nurse anticipate? Select all that apply.