Gastric lavage and administration of activated charcoal are prescribed for an unconscious patient who has been admitted to the emergency department (ED) after ingesting 30 lorazepam (Ativan) tablets. Which prescribed action should the nurse plan to do first?

Prepare a 60-mL syringe with saline.

Assist with intubation of the patient.

Give first dose of activated charcoal.

Insert a large-bore orogastric tube.

Answer and Explanation

The Correct Answer is B

A. Preparing a 60-mL syringe with saline may be necessary for gastric lavage but is not the first action.
B. For an unconscious patient who has ingested a significant quantity of lorazepam, securing the airway is the most critical first step to prevent aspiration and ensure the patient can breathe. Therefore, the nurse should assist with intubation of the patient.
C. The initial step is to ensure that the client’s airway is secured through intubation before administration of activated charcoal.
D. Inserting a large-bore orogastric tube may be necessary for gastric lavage but typically follows administration of activated charcoal.

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Correct Answer is D

Explanation

A. Clinical breast examinations are generally recommended every 1 to 3 years for women in their 20s and 30s and annually for women 40 and older. However, the emphasis has shifted towards mammography as a primary screening tool.

B. Routine screening for colorectal cancer typically begins at age 45 for average-risk individuals, not 40. Colonoscopies are generally recommended every 10 years if results are normal.

C. Mammograms are typically recommended to start at age 40 for average-risk women, with yearly screening starting at age 45 or 50 depending on guidelines.

D. Annual testing for fecal occult blood is a recommended screening method for colorectal cancer starting at age 45, as it helps detect blood in the stool which can be an early sign of colorectal cancer.

A. A conscious adult client who reports shortness of breath, has a respiratory rate of 24/min, and capillary refill of <2 seconds B. A conscious adult client who has a dislocated right shoulder, respiratory rate of 18/min, and capillary refill of <2 seconds C. An unconscious adult client who has a sucking chest wound, respirations of 38/min, and capillary refill of <2 seconds D. An unconscious adult client who has no respirations, capillary refill is 2 seconds and paramedics have already tried to reposition airway without results

Correct Answer is C

Explanation

A. This client has respiratory distress but is conscious and stable, requiring urgent but not immediate attention compared to other critical conditions.
B. This client has a dislocated shoulder, which is painful and needs attention but is not life-threatening compared to other conditions.
C. This client is unconscious with a sucking chest wound and high respiratory rate, indicating severe respiratory compromise and needing immediate intervention to prevent further deterioration.
D. This client is also unconscious with no respirations despite attempted airway management, indicating a need for immediate resuscitative efforts, potentially including CPR.

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Gastric lavage and administration of activated charcoal are prescribed for an unconscious patient who has been admitted to the emergency department (ED) after ingesting 30 lorazepam (Ativan) tablets. Which prescribed action should the nurse plan to do first?

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