The client with Clostridium difficile in the stool receives a prescription for vancomycin PO. Which action should the nurse take before administering the first dose?

Measure oxygen saturation.

Auscultate bowel sounds.

Assess body temperature.

Check serum creatinine.

Answer and Explanation

The Correct Answer is D

Measuring oxygen saturation is not directly relevant to the administration of vancomycin or the monitoring of its potential side effects. While oxygen saturation is important to assess in patients with respiratory concerns, it does not provide information about kidney function, which is essential for safe vancomycin use.

Choice B rationale:

Auscultating bowel sounds, while a part of general abdominal assessment, is not the most crucial action before administering vancomycin. Vancomycin is not known to have significant effects on bowel motility, and its primary concern is nephrotoxicity.

Choice C rationale:

Assessing body temperature can be helpful in evaluating for infection, but it is not the most specific or sensitive indicator of vancomycin-related adverse effects. Fever can be a sign of various conditions, and it does not directly assess kidney function.

Choice D rationale:

Checking serum creatinine is the most essential action before administering vancomycin because it allows for assessment of kidney function. Vancomycin is primarily excreted by the kidneys, and impaired renal function can lead to elevated drug levels and increased risk of nephrotoxicity. By checking serum creatinine, the nurse can ensure that the patient's kidney function is adequate to safely excrete vancomycin and can adjust the dosage or frequency of administration if necessary.

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Correct Answer is C

Explanation

Choice A rationale:

Sterile gloves are not necessary for routine oral care, even in the presence of oral Candida albicans.

Standard precautions, which include the use of gloves, are sufficient to protect the UAP from exposure to blood and body fluids.

Sterile gloves would only be indicated for invasive procedures, such as oral surgery or deep tissue sampling.

Choice B rationale:

Delegating oral care to the UAP is appropriate, as it is a routine task that does not require the specialized skills of a nurse.

The nurse should provide clear instructions to the UAP on how to perform oral care, but it is not necessary for the nurse to complete the task themselves.

Choice C rationale:

Using a soft-bristled toothbrush is important for patients with oral Candida albicans, as it can help to remove plaque and debris without further irritating the delicate tissues of the mouth.

A soft-bristled toothbrush is less likely to cause bleeding or pain than a harder-bristled toothbrush.

Choice D rationale:

Mouthwash is not typically recommended for patients with oral Candida albicans, as it can actually dry out the mouth and worsen symptoms.

In some cases, a healthcare provider may prescribe a special antifungal mouthwash, but this should only be used under their supervision.

A. Colloidal oatmeal-based lotion. B. Topical corticosteroids. C. Topical analgesics. D. Topical antifungal.

Correct Answer is B

Explanation

A Colloidal oatmeal-based lotion: Colloidal oatmeal can help to reduce itching and swelling, all while hydrating the skin. It is often used to soothe irritated skin and can be incorporated into a skincare routine through oatmeal baths or oatmeal-infused moisturizers. However, it is typically used as a complementary treatment and may not be sufficient to manage psoriasis symptoms on its own.

B Topical corticosteroids: These are an essential tool for treating inflammatory skin conditions such as psoriasis34. They work by reducing inflammation and slowing down the production of skin cells, which helps to alleviate symptoms such as redness, itching, and scaling. Topical corticosteroids are often the first line of treatment for mild to moderate psoriasis.

C. Topical analgesics: These are primarily used to relieve pain. While they may provide some relief from discomfort associated with psoriasis, they do not address the underlying inflammation and rapid skin cell production that characterize this condition.

D Topical antifungal: Antifungal agents are typically used to treat conditions like seborrheic dermatitis and scalp psoriasis, or in areas where psoriasis involves folds in the skin, where there is an increased potential for localized infection. However, they are not typically used as a primary treatment for psoriasis.

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