A nurse is planning to administer the first dose of iron dextran intermittent IV bolus for a client who has iron-deficiency anemia. Which of the following interventions should the nurse plan to take?
Give a 25-mg test dose of the medication.
Flush the IV site with 3 mL of heparin following infusion.
Instruct the client to remain supine for 10 min after administration.
Dilute the medication in sterile water for injection.
The Correct Answer is D
A) Drowsiness: While drowsiness can be a sign of elevated magnesium levels, it is less critical compared to more immediate symptoms like bradycardia. Monitoring and managing drowsiness is important, but bradycardia poses a more immediate risk of severe cardiovascular issues.
B) Diminished patellar reflexes: Diminished reflexes can indicate elevated magnesium levels, but this finding is less urgent compared to symptoms directly affecting heart function. It still needs to be reported but is not the highest priority.
C) Generalized muscle weakness: Muscle weakness is another common sign of high magnesium levels, reflecting the effect of magnesium on neuromuscular function. However, it is less critical compared to bradycardia, which can be life-threatening.
D) Bradycardia: Elevated magnesium levels can significantly impact cardiac function, leading to bradycardia. Bradycardia can be life-threatening, as it may result in decreased cardiac output and potential for severe complications. Therefore, this finding requires immediate attention and should be reported to the provider first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) "A parent is supposed to pass before their child": This statement reflects ongoing grief and a struggle with the loss, indicating the client is still grappling with the emotional impact rather than moving toward reorganization and acceptance.
B) "My partner and I have plans to open a small business": This statement demonstrates that the client is beginning to focus on future goals and engaging in activities that signify a return to normalcy and investment in life. This reflects reorganization and acceptance of the loss as they are planning for the future.
C) "I have put all the pictures of my child in the attic": Putting away pictures of the child might indicate avoidance or difficulty coping with reminders of the loss. This action suggests the client may still be in the process of dealing with grief rather than having reached acceptance.
D) "My partner says I seem to forget things frequently": Frequent forgetfulness can be a symptom of ongoing grief and emotional distress. This indicates that the client may still be experiencing significant emotional and cognitive impacts from the loss.
Correct Answer is B
Explanation
A) HDL 65 mg/dL: High-density lipoprotein (HDL) levels of 65 mg/dL are considered protective against heart disease. Higher HDL levels are generally associated with a lower risk of cardiovascular disease, so this result is not a concern.
B) LDL 120 mg/dL: Low-density lipoprotein (LDL) levels of 120 mg/dL are elevated for individuals at increased risk of cardiovascular disease, especially with a family history of hyperlipidemia and cardiac disease. An LDL level above 100 mg/dL is a risk factor for heart disease, making this result important to report to the provider for potential intervention.
C) Cholesterol 195 mg/dL: A total cholesterol level of 195 mg/dL is slightly above the recommended level of less than 200 mg/dL but may not be immediately alarming unless the client has other risk factors. However, this value alone is not as critical as LDL levels in assessing risk.
D) Triglycerides 175 mg/dL: Triglyceride levels of 175 mg/dL are slightly elevated, as normal levels are typically less than 150 mg/dL. While elevated triglycerides are a risk factor for cardiovascular disease, this level is less critical compared to elevated LDL levels in the context of the client’s family history.
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