A patient is taking a drug that has known toxic side effects. What will the nurse do?
Discontinue the drug at the first signs of toxicity.
Teach the patient how to treat the symptoms if they develop.
Ensure that complete blood counts are ordered periodically.
Monitor the function of all organs potentially affected by the drug.
The Correct Answer is D
Choice A Reason:
Discontinuing the drug at the first signs of toxicity might seem like a straightforward solution, but it is not always the best approach. Some drugs are essential for treating serious conditions, and stopping them abruptly can cause more harm than good. Instead, the nurse should monitor the patient closely and consult with the healthcare provider to adjust the dosage or switch to a safer alternative if necessary.
Choice B Reason:
Teaching the patient how to treat symptoms if they develop is important, but it is not sufficient on its own. While patient education is a crucial aspect of managing drug side effects, it should be part of a broader strategy that includes regular monitoring and medical supervision.
Choice C Reason:
Ensuring that complete blood counts are ordered periodically is a good practice, especially for drugs that can affect blood cells. However, this approach is too narrow. Toxic side effects can impact various organs and systems, so a comprehensive monitoring plan is necessary.
Choice D Reason:
This is the correct answer. Monitoring the function of all organs potentially affected by the drug is the most comprehensive and effective approach. This includes regular blood tests, liver function tests, kidney function tests, and other relevant assessments. By closely monitoring the patient’s organ functions, the healthcare team can detect early signs of toxicity and take appropriate action to prevent serious complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Decreased ATP production is the primary cause of sodium and water accumulation in an injured cell. ATP is essential for the function of the sodium-potassium (Na±K+) pump, which maintains the ionic balance within the cell. When ATP levels drop, the Na±K+ pump fails, leading to an influx of sodium and water into the cell, causing cellular swelling.
Choice B Reason:
Calcification of the cell refers to the abnormal deposition of calcium salts within the cell. While calcification can occur in injured cells, it is not directly responsible for sodium and water accumulation. Calcification is more related to chronic injury and cell death rather than acute cellular swelling.
Choice C Reason:
Ribosome detachment from the endoplasmic reticulum can occur due to cellular stress and injury, leading to reduced protein synthesis. However, this detachment is not the direct cause of sodium and water accumulation. The primary issue is the failure of the Na±K+ pump due to decreased ATP production.
Choice D Reason:
Dehydration refers to the loss of water from the body or cells. While dehydration can affect cellular function, it is not the cause of sodium and water accumulation in injured cells. The accumulation is primarily due to the failure of the Na±K+ pump, which is dependent on ATP.
Correct Answer is A
Explanation
Choice A Reason:
Respiratory alkalosis occurs when a person breathes rapidly (hyperventilates), causing a decrease in carbon dioxide (CO2) levels in the blood. This reduction in CO2 leads to an increase in blood pH, resulting in alkalosis. Hyperventilation can be triggered by anxiety, fever, or other conditions that increase respiratory rate.
Choice B Reason:
Metabolic alkalosis is caused by an increase in bicarbonate (HCO3-) or a loss of hydrogen ions (H+), often due to vomiting, diuretic use, or excessive bicarbonate intake. It is not directly related to hyperventilation, which primarily affects CO2 levels rather than bicarbonate levels.
Choice C Reason:
Metabolic acidosis occurs when there is an excess of acid in the body or a loss of bicarbonate, often due to conditions like diabetic ketoacidosis, renal failure, or severe diarrhea. Hyperventilation does not cause metabolic acidosis; instead, it can be a compensatory response to metabolic acidosis to help lower CO2 levels and increase pH.
Choice D Reason:
Respiratory acidosis is caused by hypoventilation, where there is inadequate removal of CO2 from the body, leading to an increase in CO2 levels and a decrease in blood pH. This condition is the opposite of what occurs during hyperventilation, making this choice incorrect.
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