A nurse is teaching a patient about taking high doses of oral glucocorticoids for an extended period to treat rheumatoid arthritis.
Which of the following instructions should the nurse include in the teaching?

Choice A rationale

Administering an antiemetic is the most appropriate initial action to address the client's reported nausea and vomiting, which are common side effects of morphine sulfate, an opioid analgesic administered via a PCA pump. An antiemetic medication can help alleviate these symptoms and improve the client's comfort.

Choice B rationale

Auscultating bowel sounds is important for assessing gastrointestinal function, but it does not directly address the client's immediate complaint of nausea and vomiting. While opioid-induced constipation and decreased bowel motility are potential side effects, the immediate priority is to relieve the distressing symptoms.

Choice C rationale

Encouraging the use of the incentive spirometer is crucial for preventing postoperative pulmonary complications such as atelectasis, especially after surgery involving anesthesia and pain medication. However, it does not directly address the client's current nausea and vomiting.

Choice D rationale

Inserting a nasogastric tube is a more invasive intervention and is typically reserved for situations involving severe, persistent vomiting, abdominal distension, or concerns about bowel obstruction. It is not the first-line treatment for nausea and vomiting related to opioid use after surgery.

Choice A rationale

Localized erythema, or redness, around a puncture wound is a classic sign of inflammation, which is an early manifestation of acute osteomyelitis, an infection of the bone. The inflammatory response causes vasodilation and increased blood flow to the infected area.

Choice B rationale

Hypothermia, or low body temperature, is not a typical manifestation of acute osteomyelitis. Fever is more common as the body mounts a systemic response to the infection. Normal body temperature is around 98.6°F (37°C).

Choice C rationale

Numbness of the toes on the affected foot suggests nerve damage or vascular compromise, which are not typical early manifestations of acute osteomyelitis resulting from a puncture wound. Pain and tenderness are more likely localized symptoms.

Choice D rationale

Bradycardia, or a slow heart rate, is not a typical finding in acute osteomyelitis. Tachycardia (rapid heart rate) might occur due to fever and the body's stress response to infection. Normal adult heart rate ranges from 60 to 100 beats per minute. .

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