In checking the dose of intravenous ticarcillin disodium prescribed for an older client, the nurse notes that the 24 hour dosage is lower than the normal range. Which finding supports the need for this reduced dosage?

Reference range

Creatinine [0.6 to 1.2 mg/dL (53 to 106 μmol/L)]

White blood cells (WBC) [5,000 to 10,000/mm3 (5 to 10 x 109/L)]

White blood cell count of 8,000/mm3 (8 X 109/L).

Inelastic skin turgor.

Serum creatinine of 3.5 mg/dL (310 μmol/L).

Thin, fragile hand and arm veins.

Answer and Explanation

The Correct Answer is C

A. A white blood cell count of 8,000/mm³ is within the normal range and does not indicate a need for dosage adjustment.
B. Inelastic skin turgor may indicate dehydration or aging but does not directly affect drug dosage.
C. Elevated serum creatinine levels indicate impaired renal function, which necessitates a reduced dosage of medications excreted through the kidneys, such as ticarcillin disodium.
D. Thin, fragile veins are a concern for intravenous access but do not affect the medication dosage.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Hypertension is not a common side effect of phenytoin. It is not typically associated with the medication.
B. Peripheral edema is not commonly linked to phenytoin use.
C. Gingival hyperplasia, or overgrowth of the gums, is a common side effect of phenytoin, particularly with long-term use.
D. Hematuria is not a typical side effect of phenytoin and may indicate a different medical issue.

A. Urinary output for past six hours. B. 24-hour medication history. C. Amount of serous drainage from the wound. D. White blood cell count.

Correct Answer is D

Explanation

A. Urinary output is important but not as critical as identifying the potential source of infection.
B. A 24-hour medication history is useful but secondary to identifying an acute infection.
C. The amount of serous drainage provides information on wound healing but does not confirm infection.
D. Increased confusion in an older adult, especially with a wound present, raises concern for infection, possibly sepsis. A WBC count can help identify infection and guide further treatment.

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Naxlex Comprehensive Predictor Exams

To detect common untoward effects of phenytoin, the nurse should assess a client with a seizure disorder for which sign or symptom?

Correct Answer is C

Explanation

An older client who is experiencing urinary incontinence is brought to the clinic with increased confusion. The nurse observes serous drainage from a laceration on the client's left arm. Which assessment is most important for the nurse to obtain?

Correct Answer is D

Explanation

The nurse is teaching a spouse how to care for a client who recently had a stroke and has residual weakness on the right side. Which style shoes should the nurse recommend the client wear when ambulating with the spouse's assistance?

An older client is admitted to the medical-surgical unit after falling and fracturing the left hip. The nurse is reviewing written preoperative instructions with the client and spouse. Which action should the nurse implement while providing these instructions?

Which intervention is most important for the nurse to implement when administering medications?

A client taking temazepam informs the nurse of plans to quit taking the medication due to feelings of "hungover" the next day. Which action should the nurse implement?

A client with heart failure reports increased shortness of breath. The nurse administered furosemide 20 mg IV 60 minutes ago. Which action is most important for the nurse to implement?

A parent brings a preteen daughter to the clinic for her first female examination. During the health assessment, the nurse should implement which technique to determine if the client has reached the age of menarche?