A nurse is planning care for a client who has acute pancreatitis. Which of the following interventions should the nurse include in the client’s plan? (Select all that apply.)

Initiate insulin drip.

Monitor blood glucose levels.

Continue regular diet as tolerated.

Maintain NPO status until pain-free.

Manage acute pain.

Answer and Explanation

Correct Answer : B,E

Choice A Reason:

Initiating an insulin drip is not a standard intervention for all clients with acute pancreatitis. This intervention is typically reserved for clients who develop hyperglycemia or diabetes as a complication of pancreatitis. Acute pancreatitis can affect the pancreas’ ability to produce insulin, but not all clients will require an insulin drip.

Choice B Reason:

Monitoring blood glucose levels is crucial for clients with acute pancreatitis because the pancreas plays a key role in regulating blood sugar. Inflammation or damage to the pancreas can lead to fluctuations in blood glucose levels, making regular monitoring essential to manage potential hyperglycemia or hypoglycemia.

Choice C Reason:

Continuing a regular diet as tolerated is not appropriate for clients with acute pancreatitis. These clients are typically kept NPO (nothing by mouth) to rest the pancreas and reduce the secretion of pancreatic enzymes, which can exacerbate inflammation and pain.

Choice D Reason:

Maintaining NPO status until the client is pain-free is a standard intervention for acute pancreatitis. This approach helps to rest the pancreas and prevent the release of digestive enzymes that can further inflame the pancreas. Once the client is pain-free and inflammation has subsided, a gradual reintroduction of oral intake can be considered.

Choice E Reason:

Managing acute pain is a critical aspect of care for clients with acute pancreatitis. Pain management can include medications such as opioids, as well as non-pharmacological interventions like positioning and relaxation techniques. Effective pain management improves the client’s comfort and can help reduce stress on the pancreas.

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Correct Answer is C

Explanation

Choice A Reason

Lidocaine is primarily used to treat ventricular arrhythmias, such as ventricular tachycardia or ventricular fibrillation. It is not typically used for bradycardia (a heart rate of 40/min) and would not be appropriate for this scenario.

Choice B Reason

Adenosine is used to treat certain types of supraventricular tachycardia (SVT) by slowing down the heart rate. It is not indicated for bradycardia and would not be suitable for a heart rate of 40/min.

Choice C Reason

Atropine is the first-line medication for treating symptomatic bradycardia. It works by blocking the effects of the vagus nerve on the heart, thereby increasing the heart rate. Given the client’s symptoms of a low heart rate, diaphoresis, and chest pain, atropine is the appropriate choice.

Choice D Reason

Verapamil is a calcium channel blocker used to treat high blood pressure, angina, and certain types of arrhythmias. However, it is not used for bradycardia and could potentially worsen the condition by further lowering the heart rate.

A. “Your provider will use stool from your digital rectal examination to perform the test.” B. “Your provider will prescribe a stimulant laxative prior to the procedure to evacuate the bowel.” C. “You should begin annual fecal occult blood testing for colorectal cancer screening at 40 years old.” D. “You should avoid taking corticosteroids prior to testing.”

Correct Answer is D

Explanation

Choice A Reason

“Your provider will use stool from your digital rectal examination to perform the test.” This statement is incorrect. For fecal occult blood testing, stool samples are typically collected at home using a special kit provided by the healthcare provider. The samples are then sent to a lab for analysis. Using stool from a digital rectal examination is not the standard procedure for FOBT.

Choice B Reason

“Your provider will prescribe a stimulant laxative prior to the procedure to evacuate the bowel.” This statement is incorrect. Stimulant laxatives are not typically prescribed before an FOBT. The test requires a small sample of stool, and using a laxative could interfere with the results. Patients are usually advised to follow specific dietary and medication guidelines to avoid false positives or negatives.

Choice C Reason

“You should begin annual fecal occult blood testing for colorectal cancer screening at 40 years old.” This statement is incorrect. Current guidelines recommend starting colorectal cancer screening, including FOBT, at age 45 for individuals at average risk. Screening may start earlier for those with a higher risk, such as a family history of colorectal cancer.

Choice D Reason

“You should avoid taking corticosteroids prior to testing.” This is the correct statement. Corticosteroids can cause gastrointestinal irritation and bleeding, which may lead to false-positive results in fecal occult blood tests. Therefore, it is important to avoid these medications before testing.

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A nurse is planning care for a client who has acute pancreatitis. Which of the following interventions should the nurse include in the client’s plan? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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