A nurse is caring for a client immediately following a hemodialysis treatment. For which of the following manifestations will the nurse administer a PRN dose of phenytoin?
Headache, restlessness
Decreased blood pressure, rapid pulse
Muscle cramps, chest heaviness
Pain and tingling at the access site
The Correct Answer is A
The correct answer is Choice A
Choice A rationale: Headache and restlessness can be signs of a seizure or neurological disturbance, which phenytoin is used to treat. Phenytoin is an anticonvulsant medication that helps control seizures by stabilizing neuronal membranes and reducing excitability.
Choice B rationale: Decreased blood pressure and rapid pulse are not indications for phenytoin administration. These symptoms may suggest hypotension or cardiovascular issues, which require different interventions such as fluid resuscitation or vasopressors.
Choice C rationale: Muscle cramps and chest heaviness are not treated with phenytoin. These symptoms could indicate electrolyte imbalances or cardiac issues, which need specific treatments like electrolyte replacement or cardiac monitoring.
Choice D rationale: Pain and tingling at the access site are not indications for phenytoin administration. These symptoms may suggest local irritation or infection at the dialysis access site, requiring appropriate wound care or antibiotics.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A reason: Proper perineal care is crucial in preventing UTIs, especially in a skilled nursing facility where clients may need assistance with personal hygiene.
Choice B reason: Catheters should be discontinued as soon as medically feasible because they can be a source of infection.
Choice C reason: It is important to complete the full course of prescribed antibiotics to ensure all bacteria are eradicated and to prevent antibiotic resistance.
Choice D reason: Encouraging clients to urinate regularly and completely empty their bladder can help ?ush out bacteria and prevent UTIs.
Choice E reason: Adequate fluid intake is essential to help dilute urine and ?ush bacteria from the urinary tract.
Correct Answer is ["A","C","D","E"]
Explanation
Choice A reason: Pruritus, or severe itching, is a common symptom in patients with ESRD due to the build-up of waste products in the body.
Choice B reason: Slurred speech is not typically associated with ESRD. It may be a symptom of other neurological conditions or could be related to medications or treatments.
Choice C reason: Hypotension can be an expected finding in ESRD due to the fluid shifts and changes in blood volume
that occur during dialysis treatment.
Choice D reason: Bone pain is a known complication of ESRD, often resulting from the mineral and bone disorders that are part of chronic kidney disease-mineral and bone disorder (CKD-MBD).
Choice E reason: Bradypnea, or abnormally slow breathing, may occur in ESRD as a result of metabolic changes affecting the respiratory system.
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