A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?

Choice A Reason:

Tertiary prevention focuses on managing and mitigating the complications of an existing disease to prevent further deterioration. For obesity, this might involve interventions like bariatric surgery or intensive management of comorbid conditions such as diabetes or cardiovascular disease. In this scenario, the goal is not to prevent the onset of disease but to manage its long-term effects and improve quality of life.

Choice B Reason:

Disease treatment refers to the direct management of a diagnosed condition. For a diabetic teen, this could include medications like insulin or metformin, regular monitoring of blood glucose levels, and other medical interventions to control diabetes. While a low-calorie diet and exercise are important components of diabetes management, they are more aligned with preventive measures rather than direct treatment.

Choice C Reason:

Secondary prevention aims to detect and address a disease early in its course to prevent progression. This might include screening programs, early interventions, and lifestyle modifications for individuals at high risk of developing a condition. In the context of diabetes, secondary prevention could involve regular blood glucose monitoring and early dietary changes to prevent the progression from prediabetes to diabetes.

Choice D Reason:

Primary prevention involves measures taken to prevent the onset of a disease before it occurs. This includes lifestyle interventions such as a healthy diet, regular physical activity, and maintaining a healthy weight. For an obese diabetic teen, a prescription for a low-calorie diet and exercise program is aimed at preventing further weight gain and reducing the risk of developing additional health complications, making it a primary prevention strategy.

Choice A Reason:

Acidosis is indicated by a pH lower than the normal range of 7.35-7.45. In this case, the patient’s pH is 7.3, which confirms acidosis. Acidosis can be caused by either respiratory or metabolic factors, but the low pH alone confirms the presence of acidosis.

Choice B Reason:

Compensation refers to the body’s attempt to return the pH to normal by adjusting the levels of CO2 or HCO3-. In this case, the HCO3- level is within the normal range (22-26 mEq/L), indicating that there is no metabolic compensation occurring. Therefore, this choice is incorrect.

Choice C Reason:

Respiratory acidosis is indicated by an elevated PaCO2 level, which is higher than the normal range of 36-44 mmHg. The patient’s PaCO2 is 48 mmHg, suggesting that the acidosis is due to respiratory factors. This is consistent with the patient’s history of smoking and symptoms of respiratory distress.

Choice D Reason:

Alkalosis is indicated by a pH higher than the normal range of 7.35-7.45. Since the patient’s pH is 7.3, which is below the normal range, this indicates acidosis, not alkalosis. Therefore, this choice is incorrect.

Choice E Reason:

Metabolic acidosis is indicated by a low HCO3- level. In this case, the patient’s HCO3- level is within the normal range (25 mEq/L), indicating that the acidosis is not metabolic. Therefore, this choice is incorrect.