Mrs. Kalen is a 70-year-old female who has arrived at the ER due to persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. Based on the acid-base interruption from Mrs. Kalen, what can the nurse anticipate the treatment will be for correcting this imbalance?

administration of antiemetics

administration of diuretics

Possible Electrolyte replacement if warranted

Administration of IV 0.9 Saline Solution infusion

Have the patient go home and rest. It will resolve itself shortly.

Answer and Explanation

The Correct Answer is D

Mrs. Kalen is diagnosed with gastroenteritis and dehydration, and the arterial blood gas results indicate metabolic alkalosis (elevated pH and HCO3-). This suggests that there is an excessive loss of gastric acid and chloride ions from vomiting, leading to an imbalance of electrolytes and an increase in bicarbonate levels.

To correct the imbalance and treat dehydration, the primary intervention is fluid replacement. Administration of IV 0.9 Saline Solution, also known as normal saline, is commonly used for fluid resuscitation and rehydration. This isotonic solution helps restore fluid balance and electrolyte levels in the body.

Administration of antiemetics may help control vomiting, but the primary treatment focus in this case is fluid and electrolyte replacement to correct dehydration and the associated metabolic alkalosis.

Administration of diuretics, which increase urine output, would not be appropriate in this case as the patient is already experiencing dehydration.

Electrolyte replacement may be necessary if there are specific electrolyte imbalances identified, but the primary treatment is fluid replacement with IV saline solution.

Having the patient go home and rest without addressing the underlying dehydration and metabolic alkalosis would not be appropriate as it can lead to further complications.

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Correct Answer is B

Explanation

Gentamicin is an antibiotic that is usually administered via IV infusion. The peak level is the highest concentration of the medication in the bloodstream, and it is important to monitor it to ensure therapeutic levels are achieved without reaching toxic levels.

Drawing the peak level 30 minutes after the infusion is complete allows enough time for the medication to distribute throughout the body and reach its peak concentration. This timing provides an accurate representation of the highest drug concentration in the bloodstream. 30 minutes before starting the infusion: Drawing the peak level before starting the infusion would not accurately reflect the peak concentration of the medication in the bloodstream. Immediately before the next dose of Gentamicin: Drawing the peak level immediately before the next dose would not provide an accurate assessment of the highest drug concentration, as the levels would have started to decrease due to elimination.

1 hour after infusion is complete: Waiting for 1 hour after the infusion is complete may result in missing the actual peak concentration of the medication in the bloodstream, as it may have already started to decline.

A. "I have learned some relaxation strategies that decrease my stress." B. "I should stop all my medications if I develop any side effects." C. "I should continue my treatment regimen as long as I have pain." D. "I can buy whatever antacids are on sale because they all have the same effect."

Correct Answer is A

Explanation

Effective teaching for a patient with peptic ulcer disease focuses on promoting understanding and adherence to the treatment plan, as well as addressing lifestyle modifications that can help manage the condition. Stress reduction is an important aspect of ulcer management, as stress

can exacerbate symptoms and delay healing. If the patient acknowledges learning relaxation strategies that decrease their stress, it indicates that they have grasped the concept and are likely to implement it in their daily life.

It is crucial for the patient to understand that any potential side effects should be reported to the healthcare provider, who will then determine the appropriate course of action. Abruptly stopping medications without medical guidance can have adverse consequences. While pain relief is an important goal, the treatment for peptic ulcer disease typically involves addressing the underlying cause, such as Helicobacter pylori infection or reducing stomach acid production. The patient should follow the treatment regimen as prescribed by the healthcare provider, even if they experience pain relief, to ensure proper healing and prevent ulcer recurrence.

Different antacids have different formulations and ingredients, and they may vary in terms of effectiveness and duration of action. It is important for the patient to consult with their healthcare provider or pharmacist to determine which antacid is most suitable for their specific needs.

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Naxlex Comprehensive Predictor Exams

The nurse receives an order to draw a peak level on a patient prescribed Gentamicin via Intravenous (IV) infusion. When is the best time for the nurse to draw this peak level?

Correct Answer is B

Explanation

The nurse determines that teaching for the patient with peptic ulcer disease has been effective when the patient makes which statement?

Correct Answer is A

Explanation

Which medication should the nurse anticipate being used first in the emergency department for relief of severe respiratory distress related to asthma?

A client is suffering from osteoarthritis in the knees and the nurse is providing care. The nurse is assessing the client's pain level and pain tolerance. Based on the nurse's understanding of pain, the nurse knows that a client's pain tolerance is most likely relieved by which of the following?

Match using the choices provided:

A nurse practitioner orders 1 liter of 0.9% normal saline to infuse over 6 hours. How many milliliters per hour will the nurse program the IV infusion device? Round off.

A patient, age 23, underwent a rhinoplasty 6 hours ago. After administering his pain medication, the nurse notes that he is swallowing frequently. What is the most likely cause of the swallowing?

Select Dropdowns: Aminoglycosides work by binding to the dropdown which prevents dropdown