A nurse is preparing to insert a miconazole vaginal suppository for a client who has vulvovaginal candidiasis. Which of the following actions is appropriate for inserting this medication?

Assist the client to a left lateral position.

Insert the suppository along the posterior wall of the vaginal canal

Apply a light coating of petroleum jelly to the suppository.

Put on sterile gloves before handling the suppository.

Answer and Explanation

The Correct Answer is B

A. Assist the client to a left lateral position. The preferred position for vaginal suppository insertion is the dorsal recumbent (lying on the back with knees bent) or the lithotomy position. The left lateral position is typically used for rectal suppository administration, not vaginal medication insertion.

B. Insert the suppository along the posterior wall of the vaginal canal. The suppository should be inserted along the posterior vaginal wall, as this allows for proper absorption and helps ensure the medication remains in place. The client should be advised to lie down for at least 10-15 minutes after insertion to prevent the suppository from slipping out.

C. Apply a light coating of petroleum jelly to the suppository. Petroleum jelly should never be used as it can interfere with medication absorption and may break down the suppository. If lubrication is needed, a small amount of water-soluble lubricant (e.g., KY Jelly) can be applied to facilitate insertion.

D. Put on sterile gloves before handling the suppository. Clean gloves (not sterile gloves) are sufficient for vaginal suppository administration. The vaginal canal is not a sterile environment, so strict aseptic technique is not required. However, proper hand hygiene and glove use are essential to prevent contamination and infection.

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Correct Answer is B

Explanation

A. Orthostatic hypotension. Prednisone does not typically cause orthostatic hypotension. Instead, corticosteroids can lead to fluid retention and hypertension due to their effects on sodium and water balance. Orthostatic hypotension is more commonly associated with medications such as diuretics or antihypertensives.

B. Hyperglycemia. Prednisone is a glucocorticoid that increases blood glucose levels by enhancing gluconeogenesis and reducing insulin sensitivity. This effect can make blood sugar more difficult to control in clients who take insulin, potentially requiring higher insulin doses to maintain glycemic control. Clients with diabetes or those taking insulin should closely monitor their blood glucose levels while on prednisone.

C. Paresthesia. Paresthesia (numbness or tingling) is not a common adverse effect of prednisone or a direct interaction with insulin. While uncontrolled diabetes can cause diabetic neuropathy, prednisone does not typically cause neurological symptoms like tingling.

D. Jaundice. Prednisone is not commonly associated with hepatotoxicity or liver dysfunction leading to jaundice. However, long-term corticosteroid use may increase liver enzyme levels, but it does not typically cause direct liver damage or bile obstruction. Jaundice would require evaluation for other underlying liver conditions.

A. Anorexia B. Arthralgia C. Nausea D. Wheezing

Correct Answer is D

Explanation

A. Anorexia. Anorexia is a common side effect of sulfasalazine and is usually mild. It occurs due to the drug’s gastrointestinal effects but does not require immediate intervention. Managing symptoms with dietary modifications or taking the medication with food can help alleviate discomfort.

B. Arthralgia. Joint pain (arthralgia) can develop as a side effect of sulfasalazine, sometimes due to a drug-induced lupus-like reaction. Although it can cause discomfort, it is not immediately life-threatening. Monitoring symptoms and adjusting treatment may help manage this condition.

C. Nausea. Nausea frequently occurs with sulfasalazine use and is typically mild. It is often dose-dependent and can be managed by taking the medication with meals. While persistent nausea may require adjustments, it is not a medical emergency.

D. Wheezing. Wheezing suggests a hypersensitivity reaction, which can lead to anaphylaxis, a life-threatening emergency. Sulfasalazine contains a sulfa component, which may trigger bronchospasm, angioedema, or respiratory distress. Immediate intervention, including discontinuing the drug and administering emergency treatment, is necessary.

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A nurse is preparing to insert a miconazole vaginal suppository for a client who has vulvovaginal candidiasis. Which of the following actions is appropriate for inserting this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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