An older client is being admitted to a rehabilitation unit from a medical-surgical unit following a left hip replacement. When reviewing the client's prescribed medications, which intervention should the nurse implement first?

Reconcile prescribed medication dosages with the published recommended dosage ranges.

Compare admission prescriptions with the list of medications previously taken by the client.

Determine which medications may be given in generic form rather than brand name only.

Provide client teaching regarding the desired effects of the client's admission prescriptions.

Answer and Explanation

The Correct Answer is B

A.   Reconciling medication dosages is important but comes after verifying the accuracy of the prescriptions.
B.   Comparing admission prescriptions with the client's previous medication list ensures continuity of care and prevents omissions or duplications.
C.   Determining generic versus brand name medications can be addressed later after ensuring medication accuracy.
D.   Client teaching is important but should follow the verification of the client's current medications.

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Correct Answer is ["22"]

Explanation

To calculate the drip rate for an IV, you can use the formula: (Volume to be infused (mL) x Drop factor (gtt/mL)) / Time (min). For the prescribed 1 unit of PRBC at 350 mL to be infused over 4 hours with a drop factor of 15 gtt/mL, the calculation would be: (350 mL x 15 gtt/mL) / (4 hours x 60 minutes/hour). This simplifies to (5250 gtt) / (240 min), which equals 21.875 gtt/min. When rounded to the nearest whole number, the nurse should regulate the infusion to 22 gtt/min.

A. Administering antipyretic medication as needed B. Educating client and family on the importance of fluid restrictions C. Collaborating with dietician to prepare low protein diet D. Monitoring fluid status E. Investigating acid/base complication F. Assessing for worsening respiratory status G. Performing diagnostic testing to determine cause of fever H. Reassessing vital signs I. Identifying cardiac arrhythmias

Correct Answer is ["D","F","I"]

Explanation

A. Administering antipyretic medication as needed is important for managing the client's fever and improving comfort, but not as urgent as monitoring fluid, respiratory status, and cardiac function.
B. Client and family education on fluid management is important but can be addressed after assessing hydration status.
C. Protein restriction might be necessary for CKD management in the long term, but not the most pressing need right now.
D. Given the client's history of chronic kidney disease, monitoring fluid status is crucial to prevent fluid overload and ensure adequate kidney function. Accurate intake and output measurements, along with daily weights, are essential.
E. The bicarbonate level (18 mEq/L) is slightly low, but further investigation can come after addressing the infection.
F. The chest X-ray shows bibasilar infiltrates, and the client has a high respiratory rate.

Continuous assessment of respiratory status is important to detect any signs of respiratory distress or infection, which may require immediate intervention.
G. Performing diagnostic testing to determine cause of fever is necessary for identifying the underlying infection, but secondary to immediate stabilization efforts.
H. Reassessing vital signs is vital for ongoing assessment, but integrated into the monitoring of fluid status, respiratory status, and cardiac function.

I. The client has an elevated potassium level and an irregular heart rate, putting him at risk for cardiac arrhythmias. Continuous ECG monitoring and immediate identification of any arrhythmias are critical to prevent cardiac complications.

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An older client is being admitted to a rehabilitation unit from a medical-surgical unit following a left hip replacement. When reviewing the client's prescribed medications, which intervention should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The healthcare provider prescribes 1 unit (350 mL) of packed red blood cells (PRBC) to infuse over 4 hours. The IV administration set delivers 15 gtt/mL. How many gtt/min should the nurse regulate the infusion? (Enter the numeric value only. Round to the nearest whole number.)

Correct Answer is ["22"]

Explanation

Patient Data Exhibits The healthcare provider has assessed the client and completes initial prescriptions. Which three interventions should the nurse prioritize for this client?

Correct Answer is ["D","F","I"]

Explanation

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