A nurse is caring for a client in the emergency department (ED)
Drag 1 medication and 1 client finding to fill in each blank in the following sentence.
The nurse should anticipate a provider prescription for
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Rationale for Correct Choices:
- Diltiazem: Diltiazem is a calcium channel blocker commonly used to control ventricular rate in atrial fibrillation. The client’s ECG confirms atrial fibrillation with rapid ventricular response, making rate control a priority to prevent hemodynamic instability.
- Cardiac rhythm: The rapid, irregular heart rate documented on ECG is the primary finding necessitating medication intervention to prevent further complications such as decreased cardiac output or thromboembolism.
Rationale for Incorrect Choices:
- Dopamine: Dopamine is a vasopressor used to support blood pressure in hypotension or shock. While the client’s BP is mildly decreased, the immediate concern is rapid atrial fibrillation rather than hypotensive crisis.
- Furosemide: Furosemide treats fluid overload and edema but does not directly address the acute arrhythmia causing tachycardia and hemodynamic compromise.
- Albuterol nebulizer: Albuterol is used for bronchospasm and respiratory distress related to airway constriction. The client has clear lung sounds, so this is not indicated.
- Alprazolam: Alprazolam can reduce anxiety but does not manage the underlying atrial fibrillation or prevent cardiovascular complications.
- Edema, blood pressure, anxiety, dyspnea: While these are relevant assessments, they are secondary to the urgent need to control the cardiac rhythm in acute atrial fibrillation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Thyroid-stimulating hormone level: TSH levels are used to assess thyroid function and are not affected by vancomycin therapy. Monitoring TSH is unrelated to safe administration of this antibiotic.
B. Blood glucose level: Blood glucose monitoring is important for clients with diabetes or receiving medications that affect glucose, but it is not directly relevant to vancomycin dosing or toxicity.
C. Total iron-binding count: Total iron-binding capacity reflects iron status and is unrelated to vancomycin therapy. It does not influence dosing or safety considerations for this antibiotic.
D. BUN level: Vancomycin is nephrotoxic, and kidney function must be monitored to prevent accumulation and toxicity. Blood urea nitrogen (BUN) provides an indicator of renal function, and reviewing it prior to the next dose helps ensure safe administration.
Correct Answer is C
Explanation
A. drops/mL: Drops per milliliter is a measurement used to calculate manual drip rates but is not a unit used when programming an electronic IV pump.
B. drops/min: Drops per minute is relevant for manual infusion via gravity drip sets. IV pumps require volumetric input rather than counting drops per minute.
C. mL/hr: Intravenous pumps are programmed to deliver fluids in milliliters per hour. This unit allows precise control of the infusion rate and ensures accurate fluid replacement for a client with fluid volume deficit.
D. units/hr: Units per hour are typically used for medications like insulin or heparin. This unit is not appropriate for general IV fluid administration.
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