Exhibits

Considering the provider orders, which should the nurse monitor most closely for possible complications, given the client's history and condition?

Famotidine 20mg IV

Placement of sequential compression stockings

Cefepime 2gm IV every 12 hours

Lactated Ringers at 170mL/hr

Answer and Explanation

The Correct Answer is D

A. Famotidine 20mg IV: Famotidine is a histamine-2 receptor antagonist used to reduce stomach acid, typically for stress ulcers. While monitoring is necessary for side effects (e.g., headache or dizziness), it is not as urgent as managing fluid balance in this patient with CHF.

B. Placement of sequential compression stockings: The use of sequential compression stockings helps prevent deep vein thrombosis (DVT) in immobilized patients. This is important for the patient’s post-operative recovery, but it is not as vital as monitoring the patient’s fluid status in this CHF and diuresis patient.

C. Cefepime 2gm IV every 12 hours: Cefepime is an antibiotic prescribed to treat a suspected infection, indicated by the patient’s fever and elevated WBC. While monitoring for potential allergic reactions or side effects is important, the fluid management takes precedence due to the patient's underlying CHF.

D. Lactated Ringers at 170mL/hr: The patient has a history of congestive heart failure (CHF), and aggressive fluid resuscitation could exacerbate fluid overload and worsen heart failure symptoms. Close monitoring of fluid status is crucial to avoid complications such as pulmonary edema or worsening CHF.

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Correct Answer is ["A","B","E"]

Explanation

A. Apply compression stockings: Compression stockings help improve venous return and prevent blood stasis in the lower extremities, which is a major risk factor for deep vein thrombosis (DVT) and pulmonary embolism.

B. Ambulate the client early: Early ambulation is one of the most effective ways to reduce the risk of venous thromboembolism, including pulmonary embolism, by promoting circulation and preventing blood stasis.

C. Administer aspirin and warfarin: While anticoagulants such as warfarin may be used in certain high-risk patients, they are not typically prescribed immediately postoperatively unless indicated by specific risk factors.

D. Maintain the head of the bed at 90 degrees: Keeping the head of the bed at 90 degrees does not directly impact the risk of pulmonary embolism. It is more important to maintain the head of the bed at 30-45 degrees to promote comfort and prevent complications like deep vein thrombosis or respiratory distress.

E. Encourage client to do active leg exercises: Active leg exercises, such as ankle pumps, help stimulate circulation and reduce the risk of blood clots, which can ultimately decrease the risk of pulmonary embolism.

A. Eating spicy foods and laid-back attitude B. Occasional alcohol and cocaine use C. Alcohol abuse and smoking D. Six-month history of H. Pylori E. Active lifestyle and smoking

Correct Answer is ["C","D"]

Explanation

A. Eating spicy foods and laid-back attitude: While spicy foods may cause discomfort in some individuals, they are not direct causes of PUD. A "laid-back attitude" is also not a recognized risk factor. Stress, in general, can worsen symptoms, but it does not cause ulcers.

B. Occasional alcohol and cocaine use: Occasional alcohol use may irritate the stomach lining, but it is more commonly chronic alcohol use that is a risk factor. Cocaine use can cause severe gastrointestinal issues, including ulcers, but occasional use is not a primary risk factor.

C. Alcohol abuse and smoking: Both alcohol abuse and smoking are well-established risk factors for peptic ulcer disease. Alcohol can irritate the stomach lining, and smoking reduces the effectiveness of treatments and increases the risk of ulcer recurrence by promoting gastric acid secretion and decreasing mucosal blood flow.

D. Six-month history of H. Pylori: Helicobacter pylori infection is one of the leading causes of peptic ulcers. A six-month history of H. pylori infection increases the risk of developing ulcers, as the bacteria damages the stomach lining and increases acid production.

E. Active lifestyle and smoking: Smoking impairs healing and increases the recurrence rate of ulcers, making it a key factor in ulcer formation. However, the active lifestyle itself does not contribute to the development of ulcers.

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Exhibits Considering the provider orders, which should the nurse monitor most closely for possible complications, given the client's history and condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is working on a surgical unit and is caring for a client who returned from the Post Anesthesia Care Unit (PACU) 90-minutes ago. Which interventions will decrease the client's risk of developing a pulmonary embolism? (Select All that Apply.)

Correct Answer is ["A","B","E"]

Explanation

Correct Answer is ["C","D"]

Explanation

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Exhibits

Considering the provider orders, which should the nurse monitor most closely for possible complications, given the client's history and condition?