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A nurse is caring for a 38-year-old client who presents to the emergency department (ED) in pain.

Exhibits

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

A.

Intravenous fluid administration

B.

Ice packs to affected area 15 min on/15 min off

C.

Ambulation in hallway with supervision

D.

Hydromorphone intravenously (IV) for pain

E.

Acetaminophen orally (PO) for pain

F.

Oxygen 2 L/min via nasal cannula

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"}}

Intravenous fluid administration is anticipated as hydration can help reduce the viscosity of sickled cells, improving circulation and potentially reducing vaso-occlusive events.

Ice packs to the affected area are nonessential and could potentially be contraindicated, as cold can cause vasoconstriction and may exacerbate pain.

Ambulation is nonessential during acute pain episodes and should be encouraged when the patient is comfortable and pain is controlled.

Hydromorphone IV for pain is anticipated because it is a stronger opioid than morphine and may be necessary if the pain is unresponsive to oral morphine sulfate.

Acetaminophen PO for pain is nonessential in this scenario as it is unlikely to provide adequate pain relief for severe vaso-occlusive pain.

Oxygen therapy is nonessential given the client's SpO2 is 95% on room air, indicating adequate oxygen saturation; however, it may be considered if there is evidence of hypoxia or respiratory distress. It is crucial to monitor the client's response to pain management interventions and adjust the treatment plan accordingly.


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Related Questions

Correct Answer is C

Explanation

A. A higher fluid intake, ideally 2 to 3 liters per day, is typically recommended to help flush uric acid from the body and prevent gout attacks, not just 1 to 1.5 L.
B. Aspirin is not recommended for gout pain management; nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids are more appropriate.
C. Focusing on losing weight to achieve a normal BMI is important for managing gout, as obesity is a risk factor for gout and can exacerbate symptoms. Weight loss can help reduce uric acid levels and improve overall management of the condition.
D. Allopurinol is used for long-term management to reduce uric acid levels and prevent attacks, but it is not used during acute attacks. Colchicine or NSAIDs are more appropriate for acute gout attacks.

Correct Answer is ["11.074"]

Explanation

To calculate the infusion rate, we'll use the following formula:

Infusion rate (mL/hr) = Desired dose (units/hr) / Concentration of heparin (units/mL)

First, calculate the desired dose in units/hr:

  • 14 units/kg/hr x 79.1 kg = 1107.4 units/hr

Next, calculate the concentration of heparin in the IV bag:

  • 25,000 units / 250 mL = 100 units/mL

Finally, plug the values into the formula:

  • Infusion rate = 1107.4 units/hr / 100 units/mL = 11.074 mL/hr

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