A nurse is planning to apply a transdermal analgesic cream prior to inserting an IV for a preschool-age child. Which of the following actions should the nurse plan to take? (Select all that apply)

Cleanse the skin prior to procedure

Apply the medication an hour before the procedure begins

Use a visual pain rating scale to evaluate effectiveness of the treatment

Apply to intact skin

Spread the cream over the lateral surface of both forearms

Answer and Explanation

Correct Answer : A,B,C,D

A. Cleanse the skin prior to the procedure: Cleansing the skin before applying the transdermal analgesic cream is essential to remove any dirt, oils, or contaminants that could interfere with its absorption. This step helps ensure optimal drug delivery and effectiveness.
B. Apply the medication an hour before the procedure begins: Applying the transdermal analgesic cream an hour before the procedure allows sufficient time for the medication to be absorbed through the skin and reach its therapeutic effect. This timing ensures that the analgesic properties are in place when the IV insertion procedure starts.
C. Use a visual pain rating scale to evaluate the effectiveness of the treatment: Using a visual pain rating scale can help assess the child's pain level before and after applying the transdermal analgesic cream. This evaluation provides valuable feedback on the cream's effectiveness in providing pain relief.
D. Apply to intact skin: Transdermal medications are designed to be absorbed through intact skin. Applying the cream to intact skin ensures proper absorption and effectiveness of the analgesic medication.
E. Spread the cream over the lateral surface of both forearms. This option might not be necessary or appropriate for the intended purpose. The choice of application site for transdermal analgesic cream depends on the specific medication and the area of pain. While the lateral surface of the forearms can be a suitable site, it may not always be necessary or feasible to apply the cream to both forearms, especially if the intended IV insertion site is on one arm.

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Correct Answer is D

Explanation

A. Instruct the client to sit down and stop pacing: Instructing the client to sit down and stop pacing may escalate the client's anxiety and agitation. It's important to provide support and assistance rather than giving orders that could exacerbate the situation.
B. Have a staff member escort the client to her room: Forcing the client to go to her room may increase feelings of being trapped or controlled, potentially worsening the anxiety. It's important to respect the client's autonomy and provide support in a less restrictive manner.
C. Allow the client to pace alone until physically tired: While it's important to allow clients some degree of autonomy, pacing alone may not effectively address the client's escalating anxiety. The nurse should remain engaged and offer support during this time.
D. Walk with the client at a gradually slower pace: This is the most appropriate action. Walking alongside the client allows the nurse to provide support, demonstrate empathy, and potentially de-escalate the situation. Gradually slowing the pace can help the client regulate their own emotions and decrease anxiety. It also provides an opportunity for therapeutic communication and assessment of the client's needs.

A. "The oral medication you will take after this IV will dissolve the clot." B. "A pharmacist is the person to answer that question" C. "Heparin does not dissolve clots. It stops new clots from forming" D. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level"

Correct Answer is C

Explanation

A. "The oral medication you will take after this IV will dissolve the clot": This statement is incorrect. While anticoagulants like warfarin or direct oral anticoagulants (DOACs) may be prescribed to prevent the formation of new clots or to treat existing clots, heparin, whether administered intravenously or subcutaneously, is not typically used to dissolve existing clots.
B. "A pharmacist is the person to answer that question": This response deflects the client's question and does not provide useful information. While pharmacists are knowledgeable about medications, nurses are responsible for educating clients about their treatments and should be able to provide accurate information regarding heparin therapy.
C. "Heparin does not dissolve clots. It stops new clots from forming": This is the correct response. Heparin is an anticoagulant medication that works by inhibiting the formation of new clots rather than dissolving existing ones. It does so by inhibiting the activity of clotting factors in the blood, thus preventing the clot from enlarging or new clots from forming.
D. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level": While this statement provides information about the time required for heparin to achieve a therapeutic effect, it does not address the client's specific question about clot dissolution. Heparin's anticoagulant effects occur rapidly, but its primary action is prevention rather than dissolution of existing clots.

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A nurse is planning to apply a transdermal analgesic cream prior to inserting an IV for a preschool-age child. Which of the following actions should the nurse plan to take? (Select all that apply)

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