A nurse is planning care for a client who is receiving morphine via continuous epidural infusion.
The nurse should monitor the client for which of the following adverse effects?
Gastric bleeding.
Pruritus.
Cough.
Tachypnea.
The Correct Answer is B
Gastric bleeding can occur due to peptic ulcer disease, nonsteroidal anti inflammatory drugs (NSAIDs), or anticoagulants.
Choice C is wrong because cough is not a common adverse effect of morphine administered via continuous epidural infusion.
Cough can be caused by respiratory infections, asthma, or chronic obstructive pulmonary disease (COPD).
Choice D is wrong because tachypnea is not a common adverse effect of morphine administered via continuous epidural infusion.
Tachypnea can be caused by hypoxia, anxiety, pain, or fever. Morphine can cause respiratory depression, which is characterized by bradypnea, not tachypnea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
This is because swelling of the feet can be a sign of lithium toxicity, which is a serious condition that can occur when the level of lithium in the blood is too high. Lithium toxicity can cause confusion, irregular heartbeat, muscle weakness, and kidney problems. Therefore, the client should report any signs of lithium toxicity to their provider as soon as possible.
Choice A is wrong because limiting foods containing tyramine is not necessary for clients taking lithium. Tyramine is a substance found in some foods that can interact with certain antidepressants called monoamine oxidase inhibitors (MAOIs), but not with lithium.
Choice B is wrong because decreasing the daily sodium intake can actually increase the risk of lithium toxicity.
Sodium helps to regulate the amount of lithium in the body, so if the sodium level is low, the lithium level can rise too high.
The client should maintain a normal sodium intake and drink enough fluids while taking lithium.
Choice C is wrong because taking this medication 2 hours before a meal is not required for clients taking lithium.
Lithium can be taken with or without food, but it should be taken at the same time each day to keep a steady level in the blood.
Taking lithium 2 hours before a meal may cause stomach upset, which is a common side effect of lithium.
Correct Answer is A
Explanation
The nurse should plan to take the following action:
A) Mix the medications with a semisolid food for the client.
Mixing the medications with a semisolid food, such as applesauce or pudding, can make it easier for an older adult client with dysphagia to swallow the medications safely. It helps in reducing the risk of choking and aspiration. This approach is typically used for clients who have difficulty swallowing pills.
Options B, C, and D are not recommended for a client with dysphagia:
B) Administering more than one pill at a time can increase the risk of choking and aspiration, which should be avoided.
C) Placing medications on the back of the client's tongue can also lead to difficulty swallowing and an increased risk of aspiration.
D) Tilting the client's head back when administering medications is not recommended as it can lead to aspiration. The head should be kept in a neutral position to support safe swallowing.
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