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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason
A creatinine level of 0.8 mg/dL falls within the normal range for adults, which is typically 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females. This indicates normal kidney function and is not a cause for immediate intervention post-operatively.
Choice B Reason
A potassium level of 4.2 mEq/L is within the normal range, which is generally between 3.6 and 5.2 mEq/L. This level indicates a stable electrolyte balance and is not a cause for immediate concern following shoulder replacement surgery.
Choice C Reason
A white blood cell (WBC) count of 9,000 mm³ is within the normal range, which typically spans from 4,500 to 11,000 WBCs per mm³. This suggests there is no active infection or inflammation that requires immediate intervention.
Choice D Reason
A hemoglobin level of 7.1 g/dL is considered low, as the normal range for adult males is generally 13.8 to 17.2 g/dL and for adult females is 12.1 to 15.1 g/dL. Low hemoglobin can indicate anemia, which may be due to blood loss during surgery or other underlying conditions. This requires immediate intervention to address potential oxygenation issues and determine the cause of the anemia.
Correct Answer is A
Explanation
Choice A Reason:
Switching to heparin is not the standard response for a high INR. Heparin may be used in conjunction with warfarin when starting anticoagulation therapy, but it is not typically used as a substitute in response to an elevated INR.
Choice B Reason:
Giving the dose as prescribed would not be appropriate when the INR is significantly above the therapeutic range. Continuing the same dose could increase the risk of bleeding complications.
Choice C Reason:
Increasing the dose would be contraindicated as the INR is already too high. Increasing the warfarin dose would further elevate the INR and increase the risk of bleeding.
Choice D Reason:
Holding the dose is the correct action when the INR is significantly above the therapeutic range, which is generally between 2.0 to 3.0 for most indications. The healthcare provider should be notified, and the warfarin dose should be held until the INR returns to the therapeutic range. Vitamin K may also be administered to help lower the INR more quickly if necessary.
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