A nurse is caring for a client who has developed a paralytic ileus related to acute pancreatitis and reports pain as 8 on a scale of 0 to 10. The client has prescriptions for multiple PRN pain medications. Which of the following medications should the nurse administer?
PO oxycodone
Ibuprofen via NG tube
IV hydromorphone
Topical lidocaine patch
The Correct Answer is C
A. PO oxycodone: Oral medications are contraindicated in clients with paralytic ileus because of impaired gastrointestinal motility, which prevents proper absorption and increases the risk of gastric retention. IV administration is preferred for effective pain control in this scenario.
B. Ibuprofen via NG tube: NSAIDs can cause gastric irritation and increase the risk of gastrointestinal bleeding, especially in clients with pancreatitis. Additionally, an NG tube is not an appropriate route for medication administration in the presence of an ileus due to impaired intestinal function.
C. IV hydromorphone: IV opioids provide effective and rapid pain relief for clients with severe pain, especially when oral or enteral administration is not feasible. Hydromorphone is commonly used in acute pancreatitis because it controls pain effectively without exacerbating the underlying condition.
D. Topical lidocaine patch: While lidocaine patches provide localized pain relief, they are not sufficient for managing severe visceral pain associated with pancreatitis and ileus. Systemic analgesia via IV opioids is more appropriate for controlling this level of pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Asystole: Synchronized cardioversion is ineffective for asystole because there is no electrical activity to reset. The appropriate intervention for asystole is immediate CPR and administration of epinephrine.
B. Ventricular fibrillation: Defibrillation, not synchronized cardioversion, is the appropriate treatment for ventricular fibrillation because it is a pulseless, chaotic rhythm that requires immediate high-energy shocks.
C. Pulseless ventricular tachycardia: Pulseless ventricular tachycardia is treated with defibrillation rather than synchronized cardioversion, as there is no coordinated cardiac activity to synchronize with. CPR and advanced cardiac life support (ACLS) protocols should be initiated.
D. Atrial fibrillation: Synchronized cardioversion is indicated for atrial fibrillation, particularly when it is associated with hemodynamic instability. Cardioversion helps restore a normal sinus rhythm by delivering a shock synchronized to the R wave of the QRS complex.
Correct Answer is C
Explanation
A. Prone with the legs adducted: Prone positioning is not recommended after hip arthroplasty as it places pressure on the surgical site and does not support proper hip alignment. Adduction of the legs increases the risk of hip dislocation.
B. Side-lying on the affected side: Lying on the operative side can cause pain and increase pressure on the hip joint, which may compromise healing. It is generally recommended to avoid side-lying positions unless specifically advised by the provider.
C. Supine with the head slightly elevated: Keeping the client in a supine position with the head elevated and the legs abducted helps maintain proper hip alignment and reduces the risk of dislocation. A wedge or abduction pillow is often used to prevent the legs from crossing.
D. High-Fowler's with a pillow under the knees: A high-Fowler's position increases hip flexion beyond the recommended 90-degree limit, which can lead to dislocation. Placing a pillow under the knees can also increase the risk of venous stasis and deep vein thrombosis.
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