A nurse is caring for an oldest patient.
For each potential provider’s prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.
Ice packs to affected area 15 minutes on, 15 minutes off
Intravenous fluids (IVF) at maintenance rate
Ketorolac IV for pain
Ambulate in hallway with supervision
Meperidine IV for pain
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}
Choice A: Ice packs to affected area 15 minutes on, 15 minutes off
Reason: Ice packs are generally contraindicated for patients with sickle cell disease (SCD). The use of ice packs can cause vasoconstriction, which narrows blood vessels and reduces blood flow. This can exacerbate the pain and potentially trigger a vaso-occlusive crisis (VOC) by further restricting blood flow to the already compromised areas. Studies have shown that cold exposure can worsen pain in SCD patients, making ice packs an unsuitable option.
Choice B: Intravenous fluids (IVF) at maintenance rate
Reason: Intravenous fluids are anticipated for patients with SCD, especially during a pain crisis. Hydration is crucial as it helps to reduce the viscosity of the blood, thereby improving blood flow and reducing the likelihood of sickling. Adequate hydration can help to alleviate pain and prevent further complications. The administration of IV fluids is a standard practice in managing acute pain episodes in SCD patients.
Choice C: Ketorolac IV for pain
Reason: Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is anticipated for managing pain in SCD patients. It provides effective pain relief without the risks associated with opioids, such as respiratory depression and dependence. Ketorolac works by inhibiting the production of prostaglandins, which are involved in the inflammatory process and pain signaling. It is particularly useful for acute pain management in SCD patients.
Choice D: Ambulate in hallway with supervision
Reason: Ambulation during a pain crisis is generally contraindicated for SCD patients. Movement can increase pain and stress on the affected areas, potentially worsening the condition. During a VOC, patients are often advised to rest and avoid activities that could exacerbate the pain. While physical activity is important for overall health, it should be carefully managed and avoided during acute pain episodes.
Choice E: Meperidine IV for pain
Reason: Meperidine is contraindicated for pain management in SCD patients due to its potential for serious side effects. Meperidine can accumulate in the body and produce a toxic metabolite called normeperidine, which can cause seizures and other adverse effects. Additionally, meperidine is less effective than other opioids and has a higher risk of causing dependency and other complications. Therefore, it is not recommended for managing pain in SCD patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Handrails are present in the bathroom: Handrails in the bathroom are actually a safety feature, not a risk. They provide support and stability, helping to prevent falls, especially for individuals with decreased vision or mobility issues.
Choice B reason:
Electrical cords are placed along the walls: Electrical cords placed along the walls can pose a tripping hazard, particularly for someone with decreased vision. However, if they are secured properly and not in walkways, the risk can be minimized.
Choice C reason:
Uses a microwave for cooking: Using a microwave for cooking is generally safe and convenient for older adults, especially those with decreased vision. It reduces the risk of burns and fires compared to using a stove.
Choice D reason:
Scatter rugs are present in the kitchen: Scatter rugs are a significant safety risk for older adults, particularly those with decreased vision. They can easily cause tripping and falls, which can lead to serious injuries. It is recommended to remove scatter rugs or ensure they are non-slip and securely fastened.
Correct Answer is D
Explanation
Choice A reason: Take the Medication with Orange Juice
Taking betamethasone with orange juice is not specifically recommended. While orange juice can help with the taste of some medications, it does not have any particular benefit for betamethasone. Additionally, citrus juices can sometimes interfere with the absorption of certain medications.
Choice B reason: Take the Medication Between Meals
Taking betamethasone between meals is not advised. This medication can cause stomach upset, and taking it on an empty stomach can exacerbate this issue. It is generally recommended to take corticosteroids with food to minimize gastrointestinal discomfort.
Choice C reason: Take the Medication on an Empty Stomach
Taking betamethasone on an empty stomach is not recommended for the same reasons as above. It can lead to stomach irritation and discomfort. Taking the medication with food or milk helps to reduce these side effects.
Choice D reason: Take the Medication with Milk
Taking betamethasone with milk is the correct instruction. Milk can help to buffer the stomach lining and reduce the risk of gastrointestinal irritation, which is a common side effect of corticosteroids. This practice helps to ensure that the medication is tolerated well by the client.
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