Patient Data

Which actions should the nurse take to assure safety during morphine administration? Select all that apply.

Have a manual resuscitation bag at the bedside.

Suction the client to clear the airway.

Ask the client about other medications she takes.

Perform a 12-lead electrocardiogram.

Restrain the client with soft restraints.

Take an initial respiratory rate.

Answer and Explanation

Correct Answer : A,C,F

A. Have a manual resuscitation bag at the bedside: Because morphine can cause respiratory depression, it is critical to have emergency resuscitation equipment readily available in case the client requires assisted ventilation during an adverse reaction.

B. Suction the client to clear the airway: Routine suctioning is not necessary unless the client has secretions impairing airway patency. It is not a standard precaution for clients receiving IV morphine without signs of airway obstruction.

C. Ask the client about other medications she takes: Morphine can interact dangerously with other medications, particularly sedatives, benzodiazepines, and other central nervous system depressants. Knowing the client’s full medication list helps prevent additive respiratory depression.

D. Perform a 12-lead electrocardiogram: A 12-lead ECG is not a standard requirement when starting morphine therapy unless there are cardiac symptoms. Continuous cardiorespiratory monitoring is already ordered, and that level of cardiac surveillance is sufficient unless new cardiac concerns arise.

E. Restrain the client with soft restraints: Restraints are not appropriate unless the client becomes a danger to herself or others. Administering morphine does not justify the prophylactic use of restraints and would violate ethical care standards.

F. Take an initial respiratory rate: An initial baseline respiratory rate is critical before starting or continuing morphine, as the drug’s main risk is respiratory depression. Ongoing respiratory assessments will be essential during PCA therapy.

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Correct Answer is ["B","D","E"]

Explanation

A. Antiproliferative agents: These are primarily used in conditions like organ transplantation and autoimmune diseases to suppress cell growth. They are not indicated for the management of asthma and would not benefit the client’s respiratory symptoms.

B. Biologics: Biologics such as omalizumab (anti-IgE) or mepolizumab (anti-IL-5) are used in moderate to severe asthma cases that are not well controlled with inhaled therapies. They target specific pathways in the inflammatory process and can help reduce exacerbations in allergic or eosinophilic asthma.

C. Loop diuretic: Loop diuretics like furosemide are used to manage fluid overload in conditions like heart failure, not for airway inflammation or bronchospasm in asthma. They have no direct role in asthma management.

D. Glucocorticoids: Inhaled or systemic glucocorticoids are essential in controlling airway inflammation and preventing exacerbations in asthma. They are a cornerstone of asthma management, especially if frequent rescue inhaler use is noted.

E. Long-acting beta agonists (LABAs): LABAs like salmeterol or formoterol are used in combination with inhaled corticosteroids for maintenance therapy in moderate to severe asthma. They help provide sustained bronchodilation but are not used alone due to increased risk of asthma-related death if unpaired with a steroid.

F. Angiotensin-converting enzyme (ACE) inhibitor: ACE inhibitors are primarily used for hypertension and heart failure. They are not asthma treatments and can sometimes worsen coughing, which could complicate asthma symptoms.

A. High triglyceride levels. B. Chronic alcohol use. C. Gallstones. D. Moderate daily alcohol use. E. Pancreatitis.

Correct Answer is ["A","B","C","E"]

Explanation

Rationale:
A. High triglyceride levels: Elevated triglycerides are a major risk factor for pancreatitis because they can cause pancreatic inflammation by leading to the accumulation of free fatty acids that injure pancreatic tissue. Clients with uncontrolled lipid levels require close monitoring while on medications like liraglutide.

B. Chronic alcohol use: Long-term alcohol consumption damages the pancreas directly by promoting inflammation and fibrosis, significantly increasing the risk of pancreatitis. Chronic use compounds the pancreatitis risk when the client is also taking medications like liraglutide that carry a pancreatic warning.

C. Gallstones: Gallstones can obstruct the pancreatic duct, leading to the backflow of digestive enzymes and resulting in pancreatic inflammation. A history of gallstones makes the client particularly vulnerable to developing pancreatitis while on incretin-based therapies like liraglutide.

D. Moderate daily alcohol use: Moderate alcohol intake is less strongly associated with pancreatitis compared to heavy or chronic use. Although any alcohol use can pose some risk, moderate consumption alone is generally not considered a primary risk factor for drug-induced pancreatitis.

E. Pancreatitis: A personal history of pancreatitis indicates previous pancreatic injury, making the pancreas more susceptible to future episodes. Starting liraglutide in someone with a history of pancreatitis requires extreme caution due to the increased likelihood of recurrence.

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Patient Data Which actions should the nurse take to assure safety during morphine administration? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Which other medications might be helpful for this client in his management of asthma? Select all that apply.

Correct Answer is ["B","D","E"]

Explanation

The nurse is caring for a client with type 2 diabetes mellitus who is taking liraglutide. Which problem(s) in the client's history may increase the risk for development of pancreatitis? Select all that apply.

Correct Answer is ["A","B","C","E"]

Explanation

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Patient Data

Which actions should the nurse take to assure safety during morphine administration? Select all that apply.