A nurse is admitting a client.

Exhibits

For each potential provider's prescription, click to specify if the prescription is anticipated, nonessential, or contraindicated.

A. "Take isoniazid with an antacid.": Isoniazid should not be taken with an antacid. Antacids containing aluminium, calcium, or magnesium can reduce the absorption of isoniazid, making it less effective. Isoniazid is typically taken on an empty stomach for better absorption.

B. "Drink at least 8 ounces of water when you take the pyrazinamide tablet.": While it is generally good practice to take medications with water, this instruction is not specific to pyrazinamide.

C. "Expect your sputum cultures to be negative after 6 months of therapy.": Sputum cultures may not be negative after 6 months of therapy. Although treatment with isoniazid, rifampin, and pyrazinamide is typically effective, sputum cultures may remain positive for several months during treatment depending on severity and response to treatment.

D. "Provide a sputum specimen every 2 weeks to the clinic for testing.": Regular sputum specimens are required to monitor the effectiveness of tuberculosis treatment. Providing a sputum sample every 2 weeks is done to ensure the bacteria are being effectively eliminated and to monitor for drug resistance.

Rationale for Correct Answer:

• Patent: The nurse should determine whether the IV line is patent because a patent line ensures that medications flow freely and effectively reach the bloodstream for pain relief.
• Obstruction: The nurse should determine whether the IV line is obstructed because obstruction prevents the flow of medication through the IV line, interfering with the effectiveness of the prescribed medications.
• Medication delivery: The nurse should determine whether the IV line is obstructed because obstruction directly interferes with medication delivery, preventing pain medications from being delivered as intended.

Rationale for Incorrect Choices:

• Properly secured: While it is important for the IV line to be properly secured, this does not affect the ability of the medication to flow or reach the bloodstream. The IV line can still be obstructed even if it is properly secured, which would block medication delivery.
• Malpositioned: If the IV line is malpositioned, this could reduce the flow of medication, but it does not completely prevent medication from being delivered. Obstruction is the primary concern for ensuring the effective delivery of medication.
• Extravasation: Extravasation occurs when IV medication leaks into surrounding tissue, causing tissue damage. While this is a serious issue, it doesn’t directly affect the ability of the medication to reach the bloodstream. Obstruction is a more immediate concern as it prevents medication delivery entirely.
• Infiltration: Infiltration happens when IV medication leaks into surrounding tissues, leading to tissue damage. However, it does not stop the medication from reaching the bloodstream, unlike obstruction, which completely prevents medication delivery.
• Phlebitis: Phlebitis refers to vein inflammation, which could cause tissue damage or discomfort, but it doesn't usually obstruct the IV line completely. Obstruction, however, directly impacts medication delivery and is more critical for this patient.
• Fluid administration: Fluid administration does not directly affect the delivery of pain medications. While fluids may be necessary for hydration, obstruction in the IV line is the primary issue in ensuring the correct pain medications are delivered effectively.
• Tissue damage: Tissue damage caused by extravasation, infiltration, or phlebitis can occur when the IV line is not functioning properly, but this is secondary to the concern of whether the IV line is patent for proper medication delivery.