How would the nurse best evaluate the effectiveness of drug therapy for a client diagnosed with pneumonia being treated with amoxicillin?
Oral temperature of 100.6°F.
Pulse oximetry of 98% on room air.
Increased neutrophil count.
Adequate urine output.
The Correct Answer is B
Choice A Reason
An oral temperature of 100.6°F may indicate that the client still has a fever, which could suggest ongoing infection. However, temperature alone is not the most reliable indicator of the effectiveness of antibiotic therapy, as it can be influenced by various factors.
Choice B Reason
Pulse oximetry measures the oxygen saturation of the blood, which is a direct indicator of respiratory function. For a client with pneumonia, an improvement in oxygen saturation to 98% on room air is a strong sign that the lungs are effectively exchanging gases and that the pneumonia is resolving. This would be a clear indication that the amoxicillin is effective.
Choice C Reason
An increased neutrophil count is a sign of acute infection, but it does not directly measure the effectiveness of the antibiotic therapy. Neutrophil counts can remain elevated even as the infection is resolving, so they are not the best sole indicator of therapeutic effectiveness.
Choice D Reason
Adequate urine output is important for overall health and indicates good kidney function, but it is not a direct measure of the effectiveness of antibiotic therapy for pneumonia. Urine output does not reflect the respiratory status or the resolution of lung infection.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason
Monitoring for hypoglycemia at 1200 is not optimal because it is well past the peak action time of insulin aspart, which occurs approximately 45–90 minutes after administration. By noon, the insulin's effects are waning, and the risk of hypoglycemia is lower compared to the peak action period.
Choice B Reason
Monitoring at 1000 might still catch the tail end of the peak action time, but it is not the most likely time for hypoglycemia to occur. The nurse could miss the initial signs of hypoglycemia if monitoring starts two hours after administration.
Choice C Reason
0900 is the most appropriate time for the nurse to monitor for hypoglycemia. Insulin aspart has a rapid onset of action, peaking in about 45–90 minutes, and the effects last for 3–5 hours. Monitoring one hour after administration aligns with the start of the peak action time, when hypoglycemia is most likely to occur.
Choice D Reason
Monitoring at 1100 is less ideal because it is nearing the end of the peak action period. While there is still a risk for hypoglycemia, the highest risk would have been earlier, closer to the peak action time.
Correct Answer is A
Explanation
Choice A Reason
A hemoglobin level of 7.1 g/dL is significantly lower than the normal range, which is typically around 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. This finding is concerning as it indicates severe anemia, which can be a life-threatening condition requiring immediate intervention. Anemia can lead to tissue hypoxia as the blood's capacity to carry oxygen is diminished. In the context of peripheral arterial disease, where blood flow is already compromised, anemia can exacerbate symptoms and increase the risk of ischemic events.
Choice B Reason
Ecchymosis, or bruising, on the client's upper extremities could be a result of the antiplatelet effects of aspirin, which inhibits platelet aggregation and prolongs bleeding time. While this is a concern and warrants monitoring, it is not as immediately life-threatening as severe anemia. However, it does indicate a risk of bleeding complications, which should be addressed by the healthcare provider.
Choice C Reason
A platelet count of 148,000/uL is at the lower end of the normal range, which is approximately 150,000 to 450,000 platelets per microliter of blood. This finding should be monitored, especially in the context of aspirin therapy, which can affect platelet function. However, it is not as critical as the low hemoglobin level.
Choice D Reason
Gastrointestinal discomfort is a common side effect of aspirin due to its irritation of the stomach lining. While this symptom can be uncomfortable and may lead to more serious gastrointestinal issues such as ulcers or bleeding, it is typically not as urgent as severe anemia. The client should be evaluated for potential gastrointestinal complications of aspirin therapy.
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