A nurse is teaching a client who has a prescription for an epinephrine auto-injector. The nurse should instruct the client to take which of the following actions first?
Hold the injector in place for 10 seconds.
Massage the outer thigh for 10 seconds.
Seek immediate medical attention.
Jab the device into the outer thigh.
The Correct Answer is D
A. Hold the injector in place for 10 seconds: Holding the injector in place after administering epinephrine is not the first action the client should take. After administering epinephrine, the client should immediately seek emergency medical attention.
B. Massage the outer thigh for 10 seconds: Massaging the outer thigh is not the first action the client should take after administering epinephrine. Seeking emergency medical attention is the priority.
C. Seek immediate medical attention: After administering epinephrine for an anaphylactic reaction, the client should immediately seek emergency medical attention to receive further evaluation and treatment. Epinephrine provides temporary relief of symptoms but does not replace the need for medical evaluation and ongoing management.
D. Jab the device into the outer thigh. The client should use the epinephrine auto-injector as soon as possible after experiencing an anaphylactic reaction. The device delivers a dose of
epinephrine, which constricts blood vessels and relaxes the airways, to reverse the symptoms of anaphylaxis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A.While medication verification is important, this is not specific to administering an intermittent IV bolus. It is standard practice for high-alert medications, not routine antibiotics.
B. Flushing the IV site with sterile water prior to connecting the secondary infusion is not standard practice. Normal saline is typically used to maintain patency, but it is not necessary before connecting the secondary infusion.
C.To administer a secondary infusion (e.g., antibiotic), the secondary bag must be hung higher than the primary infusion. This allows gravity to prioritize the secondary infusion through the Y-site.
D. Disconnecting the primary IV infusion to connect the secondary infusion is not correct. The secondary infusion should connect to the primary line without disrupting the ongoing infusion unless otherwise indicated.
Correct Answer is C
Explanation
A. An increased heart rate can be a sign of dehydration and would not indicate that IV fluid replacement has been effective.
B. Excessive thirst is a symptom of dehydration and would not indicate that IV fluid replacement has been effective.
C. Moist oral mucous membranes indicate improved hydration status and are a positive response to IV fluid replacement.
D. Decreased blood pressure is a sign of dehydration and would not indicate that IV fluid replacement has been effective.
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