A nurse is caring for a client who is receiving controlled epidural analgesia infusion. Which of the following nursing actions is appropriate?
Cleansing the insertion site daily.
Covering the insertion site with a transparent dressing.
Administering supplemental opioids as needed.
Replacing the infusion tubing every 72 hr.
The Correct Answer is B
Choice A reason: Cleansing the insertion site daily is not appropriate because frequent manipulation increases the risk of introducing pathogens into the epidural space. The site should be maintained with sterile technique and minimal disturbance to reduce infection risk.
Choice B reason: Covering the insertion site with a transparent dressing is appropriate because it allows continuous visualization of the site for signs of infection or leakage while maintaining sterility. Transparent dressings also reduce the need for frequent manipulation, thereby lowering infection risk.
Choice C reason: Administering supplemental opioids without provider orders is unsafe. Epidural analgesia is tightly regulated, and additional opioids could increase the risk of respiratory depression, sedation, and overdose.
Choice D reason: Replacing infusion tubing every 72 hours is standard for IV therapy but not specific to epidural analgesia. Epidural tubing requires specialized sterile handling and should not be routinely changed unless clinically indicated.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Varenicline is used for smoking cessation by reducing nicotine cravings. It is not indicated for gambling disorder.
Choice B reason: Disulfiram is used for alcohol use disorder by causing unpleasant effects when alcohol is consumed. It does not treat gambling disorder.
Choice C reason: Sertraline, an SSRI, is correct because it can reduce compulsive behaviors and improve impulse control. SSRIs are commonly used to treat behavioral addictions such as gambling disorder.
Choice D reason: Clonidine is used for hypertension and opioid withdrawal symptoms. It does not address compulsive gambling behaviors.
Correct Answer is B
Explanation
Choice A reason: Avocados contain tyramine, which can interact with monoamine oxidase inhibitors (MAOIs) like phenelzine, leading to hypertensive crisis. This option is unsafe and incorrect.
Choice B reason: Apple slices are safe because they do not contain tyramine. They are appropriate for clients taking MAOIs and provide a healthy, low-risk snack. This makes option B the correct answer.
Choice C reason: Bologna is a processed meat that contains high levels of tyramine. Consuming it while on phenelzine can trigger dangerous hypertensive reactions. This option is incorrect.
Choice D reason: Cheddar cheese is aged and contains tyramine. Aged cheeses are contraindicated for clients taking MAOIs due to the risk of hypertensive crisis. This option is incorrect.
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