A nurse is planning care for a client who is 12 hours postoperative following a kidney transplant. Which of the following actions should the nurse include in the plan of care?

Choice A reason: Glucose Dextrose Oral (GDO) is not typically used in the immediate management of anaphylactic shock. Anaphylaxis requires rapid treatment to address severe allergic reactions and GDO does not play a role in this emergency situation.

Choice B reason: Epinephrine (Adrenaline) is the first-line treatment for anaphylactic shock. It works quickly to improve breathing, stimulate the heart, raise a dropping blood pressure, reverse hives, and reduce swelling of the face, lips, and throat.

Choice C reason: Dexamethasone (Decadron) is a corticosteroid that may be used in the treatment of anaphylaxis to reduce inflammation. However, it is not the first medication administered due to its slower onset of action compared to epinephrine.

Choice D reason: 0.9% Normal Saline is used for intravenous fluid resuscitation in anaphylactic shock but is secondary to the administration of epinephrine. It helps to maintain blood pressure and is important in the overall management but not the first medication given.

Choice A reason: Aspirating the catheter to check for a brisk blood return is not typically recommended as a routine action when replacing the dressing of a PICC line used for TPN. This action is performed to verify patency and placement of the catheter, but it is not directly related to the dressing change procedure.

Choice B reason: Using sterile technique for the procedure is essential when replacing the dressing of a PICC line. Maintaining sterility is crucial to prevent infection, as the PICC line provides direct access to the central venous system. The nurse should use sterile gloves and follow aseptic protocols to minimize the risk of introducing pathogens at the catheter insertion site.

Choice C reason: Cleansing the insertion site with hydrogen peroxide is not recommended for PICC line care. Hydrogen peroxide can be damaging to the tissue and may delay healing. Instead, a chlorhexidine-based antiseptic is typically used to clean the skin around the insertion site during dressing changes to reduce microbial flora and prevent infection.

Choice D reason: Flushing the TPN port with 20 mL of 0.9% sodium chloride is a practice used to maintain catheter patency, but it is not part of the dressing change procedure. Flushing is usually done before and after administering medication or nutrition, not specifically during a dressing change.