A nurse is preparing to apply a fentanyl transdermal patch. Which of the following actions should the nurse take?

Cleanse the application area with an alcohol swab before applying the patch.

Apply a warm compress to the patch for 10 min to enhance absorption.

Press the patch firmly into place using the palm of the hand for 30 seconds.

Discard the used patch in a clear plastic bag and place it in the trash.

Answer and Explanation

The Correct Answer is C

C. Pressing the patch helps to activate the adhesive and ensure it sticks securely to the skin. This step helps prevent the patch from coming loose, which could interfere with drug delivery.

A. Cleaning the skin with water, not an alcohol swab, helps ensure that the patch adheres well to the skin, promoting consistent drug delivery. This step also reduces the risk of skin irritation or infection.

B Heating the patch with a warm compress could potentially increase the release of fentanyl from the patch, but this method is not recommended.

D. Used fentanyl patches should be folded in half with the sticky sides together and placed in a clear plastic bag before disposal in the trash. This step helps to prevent accidental contact with the residual medication on the patch.

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Correct Answer is D

Explanation

A. Warming the PN formula to room temperature is a routine practice to make it more comfortable for administration but does not directly address hyperkalemia.

B. Lactose-free formulas may be requested for clients who have lactose intolerance or other specific dietary needs but are not directly related to hyperkalemia.

C. IV dextrose (usually in the form of dextrose 5% in water, D5W) can be used to temporarily shift potassium from the extracellular space into the cells, thereby lowering serum potassium levels. Dextrose helps in stimulating insulin release, which facilitates potassium uptake into cells, effectively lowering serum potassium levels. However, it is not the immediate action.

D. Hyperkalemia can lead to serious cardiac arrhythmias due to its effects on myocardial cell membrane potentials. Therefore, close cardiac monitoring is essential to detect any signs of cardiac instability.

Correct Answer is ["1.5"]

Explanation

Convert the client's weight from pounds to kilograms, knowing that 1 kilogram equals 2.2 pounds.

The client weighs 198 pounds, which is approximately 90 kilograms (198 lb / 2.2).

The prescription specifies a dosage of 5 micrograms per kilogram, so the client requires 450 micrograms of filgrastim (90 kg * 5 mcg/kg).

Since the available filgrastim concentration is 300 micrograms per milliliter, divide the required dose by the concentration to find the volume in milliliters: 450 mcg / 300 mcg/mL equals 1.5 mL. Therefore, the nurse should plan to administer 1.5 mL of filgrastim for each dose.

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A nurse is preparing to apply a fentanyl transdermal patch. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving parenteral nutrition and identifies that the client has hyperkalemia. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

Correct Answer is ["1.5"]

Explanation

A nurse is assessing a client who has a transdermal fentanyl patch in place. Which of the following findings should the nurse document as an adverse effect of this medication?

A nurse is preparing to administer dextrose 5% in water 500 mL over 12 hr to a client. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

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