A nurse is caring for a client who is mechanically ventilated and receiving propofol intravenously. Which of the following manifestations should the nurse identify as a complication of administration?

Hypokalemia

Sepsis

Urinary retention

Hypoglycemia

Answer and Explanation

The Correct Answer is B

B) Sepsis: Propofol is an intravenous sedative-hypnotic agent commonly used for sedation in mechanically ventilated patients. While propofol itself does not directly cause sepsis, its use can increase the risk of sepsis-related complications, such as infection. Propofol is typically administered intravenously, and improper handling or contamination of equipment, including intravenous lines and medication vials, can introduce pathogens into the bloodstream, leading to bloodstream infections (sepsis). Additionally, prolonged use of propofol may suppress immune function, further increasing the susceptibility to infection. Therefore, the nurse should monitor the client for signs and symptoms of sepsis, such as fever, chills, hypotension, tachycardia, and altered mental status, as a potential complication of propofol administration.

A) Hypokalemia: Hypokalemia, or low potassium levels, is not a common complication directly associated with propofol administration. While electrolyte imbalances may occur in critically ill patients, especially those receiving mechanical ventilation, hypokalemia is more likely to result from other factors such as diuretic therapy, gastrointestinal losses, or inadequate potassium intake.

C) Urinary retention: Urinary retention is not a typical complication of propofol administration. While sedative medications like propofol can affect bladder function, causing urinary retention in some cases, it is not a commonly reported complication of propofol use in mechanically ventilated patients.

D) Hypoglycemia: Hypoglycemia, or low blood sugar levels, is a potential complication of propofol administration, particularly in critically ill patients who may have altered glucose metabolism. However, hypoglycemia is not as commonly associated with propofol use as sepsis-related complications. Close monitoring of blood glucose levels is essential when administering propofol, especially if the client has preexisting diabetes mellitus or other risk factors for hypoglycemia. However, sepsis is a more direct and significant complication associated with propofol administration in mechanically ventilated patients.

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Correct Answer is C

Explanation

A) Ask another nurse if they are aware of potential interactions: Relying solely on another nurse's awareness of potential interactions is’not a comprehensive or reliable approach. Nurses may have varying levels of knowledge about medication interactions, and it's important to consult verified sources ’or accurate information.

B) Check the client's medical record for medication and food’interactions: While the client's medical record may contain information’about their current medications, it may not provide detailed information about potential interactions with specific foods or other medications. Additionally, relying solely on the medical record may not capture recent changes in medication or dietary intake.

C) Consult a drug reference guide for possible interactions: This is the correct action. Drug reference guides provide comprehensive information about medications, including potential interactions with other drugs and food. Nurses can access reliable drug reference guides to ensure they have accurate information before administering medications.

D) Have the client take the medication on an empty stomach to avoid interactions: Instructing the client to take medication on an empty stomach without knowledge of specific interactions could be inappropriate and potentially harmful. Some medications require administration with food to enhance absorption or reduce gastrointestinal side effects. It's essential to consult reliable sources ’o determine the appropriate administration instructions for each medication.

A. PTT B. PT C. WBC D. Total iron-binding capacity

Correct Answer is B

Explanation

A) PTT (Partial Thromboplastin Time): While the PTT is a laboratory test used to assess the intrinsic pathway of the coagulation cascade and monitor the effectiveness of heparin therapy, it is not routinely used to monitor warfarin therapy. Therefore, reviewing the PTT prior to administering warfarin is not necessary.

B) PT (Prothrombin Time): Prothrombin time measures the extrinsic pathway of the coagulation cascade and is commonly used to monitor warfarin therapy. Since warfarin works by inhibiting vitamin K-dependent clotting factors, such as factors II, VII, IX, and X, monitoring the PT allows for the assessment of the anticoagulant effect of warfarin and helps guide dosing adjustments. Therefore, reviewing the PT prior to administering warfarin is essential to ensure appropriate anticoagulation therapy.

C) WBC (White Blood Cell Count): The white blood cell count is not directly related to warfarin therapy monitoring. While an elevated white blood cell count may indicate infection, it is not specific to warfarin therapy and does not influence the administration of the medication.

D) Total iron-binding capacity: Total iron-binding capacity is a laboratory test used to assess iron status and is not relevant to monitoring warfarin therapy. It measures the body's ability to bind and transport iron in the blood, and its results are not indicative of warfarin's anticoagulant effect or dosage adjustments.

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A nurse is caring for a client who is mechanically ventilated and receiving propofol intravenously. Which of the following manifestations should the nurse identify as a complication of administration?

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