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 A

Explanation

A) Glaucoma: Atropine is contraindicated in clients with glaucoma due to its potential to exacerbate intraocular pressure. Glaucoma is a condition characterized by increased intraocular pressure, which can lead to optic nerve damage and vision loss if left untreated or if pressure is further increased. Atropine, as an anticholinergic medication, works by dilating the pupil and inhibiting accommodation, thereby increasing intraocular pressure. Administering atropine to a client with glaucoma can worsen their condition and potentially cause acute angle-closure glaucoma, which is a medical emergency. Therefore, it is essential to avoid using atropine in clients with glaucoma to prevent irreversible vision loss and other serious complications.

B) Bronchospasms: Atropine can be used to treat bronchospasms by dilating the bronchi and bronchioles, making it easier to breathe. While it may not be the first-line treatment for bronchospasms, it is not contraindicated in this condition. The bronchodilatory effects of atropine help relieve airway constriction and improve airflow, which can be beneficial in managing bronchospasms associated with conditions such as asthma or chronic obstructive pulmonary disease (COPD). Therefore, atropine can be considered as part of the treatment regimen for bronchospasms when indicated.

C) Diverticulitis: Atropine does not have any specific contraindications related to diverticulitis. However, caution should be exercised in clients with pre-existing gastrointestinal conditions due to potential anticholinergic effects, such as decreased gastrointestinal motility. While atropine can inhibit gastrointestinal motility and secretions, which may exacerbate symptoms in some individuals with diverticulitis, it is not considered a contraindication. The decision to use atropine in clients with diverticulitis should be based on the overall assessment of the client's condition and the potential benefits versus risks of treatment.

D) Diarrhea: Atropine can be used to treat diarrhea by reducing gastrointestinal motility and secretions. Therefore, it is not contraindicated in clients with diarrhea. By slowing down gastrointestinal motility and reducing secretions, atropine can help alleviate diarrhea and promote better bowel control. While other treatment options may be considered depending on the underlying cause of diarrhea, atropine can be effective in managing diarrhea associated with certain conditions or as part of a treatment regimen for specific gastrointestinal disorders.

A. Monitor the client for seizure activity. B. Check the client's urinary output. C. Monitor the client'’ oxygen saturation. D. Auscultate the c’ient's bowel sounds.

Correct Answer is C

Explanation

A) Monitor the client for seizure activity: While diazepam is an anticonvulsant medication and may be used to prevent or treat seizures, it is unlikely to cause seizure activity as an adverse reaction when administered for moderate sedation. However, if the client has a history of seizures or is at risk for seizures, monitoring for seizure activity is essential. In the context of moderate sedation, the primary concern is related to the sedative effects of diazepam rather than seizure activity.

B) Check the client's urinary output: Monitoring urinary out’ut is important for assessing renal function and fluid balance, but it is not directly related to assessing adverse reactions to diazepam. Adverse reactions to diazepam typically involve central nervous system depression, respiratory depression, or cardiovascular effects. Monitoring urinary output may be part of routine nursing care but is not specific to assessing adverse reactions to diazepam.

C) Monitor the client's oxygen saturation: This is the correct’action. Monitoring the client's oxygen saturation is essential for det’cting adverse reactions to diazepam, such as respiratory depression or hypoventilation. Diazepam can cause respiratory depression, especially when administered in higher doses or in combination with other sedative medications. Monitoring oxygen saturation allows the nurse to detect any signs of hypoxemia early and intervene promptly to ensure adequate oxygenation.

D) Auscultate the client's bowel sounds: While assessing bowel so’nds is important for evaluating gastrointestinal function, it is not directly related to assessing adverse reactions to diazepam. Adverse reactions to diazepam typically involve effects on the central nervous system and respiratory system rather than gastrointestinal function. Monitoring bowel sounds may be part of routine nursing assessment but is not specific to assessing adverse reactions to diazepam.

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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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