Five months following treatment for herpes zoster, an older adult client tells the home health nurse of continuing to experience pain where the rash occurred. Which action should the nurse implement?
Teach the client about phantom pain symptoms.
Perform a complete mental status exam.
Determine if the client has had a shingles vaccination.
Complete an assessment of the client's pain.
The Correct Answer is D
D. Persistent pain following the resolution of herpes zoster, known as postherpetic neuralgia (PHN), is a common complication, especially in older adults. PHN can cause significant discomfort and affect the client's quality of life. Therefore, it is essential for the nurse to conduct a comprehensive assessment of the client's pain to better understand its characteristics, severity, duration, aggravating or alleviating factors, and impact on daily activities.
A. Patient education should follow a complete assessment of the pain to ascertain the diagnosis.
B. Performing a complete mental status exam is not indicated solely based on the client's report of persistent pain from herpes zoster.
C. Determining if the client has had a shingles vaccination is important for preventive healthcare, but it is not the priority action in addressing the client's current pain concern related to PHN. The focus should be on assessing and managing the client's pain to improve their comfort and well-being.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Occult positive emesis refers to vomiting that occurs without the client's awareness, meaning that the vomitus may not be easily visible or readily apparent. Vomiting can lead to significant fluid loss and dehydration, which is particularly concerning in a client who has undergone a biliopancreatic diversion procedure (BDP).
A. Loose bowel movements may indicate gastrointestinal disturbances or malabsorption issues commonly seen after biliopancreatic diversion procedure (BDP). BDP involves rerouting a significant portion of the small intestine, which can affect digestion and absorption of nutrients and fluids.
C. Strong foul-smelling flatus may indicate bacterial overgrowth or malabsorption issues in the gastrointestinal tract, which can occur after BDP. While foul-smelling flatus can be uncomfortable and indicative of gastrointestinal disturbances, it may not require immediate intervention.
D. Poor night vision may suggest vitamin deficiencies, particularly deficiencies in fat-soluble vitamins such as vitamin A, which can occur after BDP due to reduced absorption of nutrients. While poor night vision should be addressed to prevent long-term complications, it may not pose an immediate threat to the client's health.
Correct Answer is C
Explanation
C. The client's symptoms of weakness and palpitations are suggestive of hypoglycemia, a common complication in individuals with diabetes, particularly those on glucose-lowering medications such as insulin or sulfonylureas. Excessive perspiration, also known as diaphoresis, is a classic symptom of hypoglycemia and indicates the body's response to low blood sugar levels.
A. Cold extremities can be a sign of poor peripheral circulation, which may occur in individuals with diabetes, particularly in advanced stages or in the presence of peripheral vascular disease. However, it is not as specific to the acute episode of hypoglycemia
B. Myalgia (muscle pain) in the wrists and hands is not a typical symptom of hypoglycemia.
D. Dark yellow urine may indicate dehydration, which can occur in individuals with poorly controlled diabetes or during episodes of hyperglycemia. While dehydration is a concern in diabetes management, it is not directly related to the acute episode of hypoglycemia.
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