The healthcare provider (HCP) prescribes pantoprazole for a client who experienced partial and full thickness burns. The client is questioning the nurse if this medication is necessary. Which action(s) should the nurse implement? Select all that apply.

May stop taking medication if no symptoms of GI discomfort.

Explain that pantoprazole may be taken with or without food.

Teach the client about risk of developing a Curling's ulcer.

Discuss the risk of gastric bleeding related to severe burns.

Tell how pantoprazole effectively heals ulcers.

Answer and Explanation

Correct Answer : B,C,D

A. May stop taking medication if no symptoms of GI discomfort: Pantoprazole is prescribed prophylactically in burn clients to prevent stress ulcers, not just to treat existing symptoms. Stopping it without medical advice could increase the risk of serious complications like gastric bleeding.

B. Explain that pantoprazole may be taken with or without food: Pantoprazole, a proton pump inhibitor (PPI), can be taken without regard to meals. Educating the client on flexible timing improves adherence and reduces confusion about the medication regimen.

C. Teach the client about risk of developing a Curling's ulcer: Severe burns increase the risk of Curling’s ulcer, a stress-related gastric ulcer. Explaining this risk helps the client understand the preventative role of pantoprazole in their overall care plan.

D. Discuss the risk of gastric bleeding related to severe burns: Gastric bleeding is a serious, potentially life-threatening complication associated with stress ulcers in burn patients. Teaching the client about this risk provides a clear rationale for continuing pantoprazole therapy.

E. Tell how pantoprazole effectively heals ulcers: While pantoprazole can treat ulcers, in this case it is prescribed to prevent ulcer formation rather than to heal an existing ulcer. The teaching should focus on prevention, not healing.

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Correct Answer is B

Explanation

A. Obtain a specimen for a urine culture: A urine culture is necessary when infection is suspected, typically indicated by symptoms like burning, urgency, or foul odor. Darker urine alone in a client on carbidopa/levodopa is not an indication for infection testing.

B. Explain the color change is normal: Carbidopa/levodopa can cause harmless discoloration of bodily fluids, including darker urine, sweat, and saliva due to the metabolism and excretion of the medication. This is a well-known and non-threatening side effect that does not require intervention beyond client reassurance.

C. Measure the client's urinary output: Monitoring urinary output is important in cases of suspected dehydration or renal dysfunction, but simply darker urine without changes in volume or symptoms does not justify additional measurement in this scenario.

D. Encourage an increase in oral intake: While adequate hydration is always encouraged, the urine color change reported here is due to the medication itself, not dehydration. Therefore, increasing fluid intake will not reverse or prevent the discoloration.

A. No known allergies B. Used for prophylaxis C. Potassium 4.4 mEq/L (4.4 mmol/L) D. Dosage in safe range E. Peripheral IV (PIV) in large vein F. Blood urea nitrogen 17 mg/dL (6.07 mmol/L)

Correct Answer is ["A","D","E","F"]

Explanation

A. No known allergies: Confirming the client has no allergies to vancomycin or related substances is critical for safe administration. Administering an antibiotic to a client with a known allergy could result in life-threatening anaphylaxis.

B. Used for prophylaxis: Although vancomycin is often used prophylactically before procedures to prevent infection, the indication alone does not ensure that it is safe to administer. Safety focuses more on client-specific factors like allergies and organ function.

C. Potassium 4.4 mEq/L (4.4 mmol/L): This is a normal potassium level and reflects good electrolyte balance but does not directly relate to the safety of administering vancomycin, which is more concerning for kidney function and allergic reactions.

D. Dosage in safe range: Verifying that the vancomycin dose is within the recommended therapeutic range is essential to prevent toxicity, particularly nephrotoxicity and ototoxicity, which are risks with improper dosing.

E. Peripheral IV (PIV) in large vein: Administering vancomycin through a large-bore IV in a large vein reduces the risk of phlebitis and tissue irritation. Proper venous access is an important safety consideration when giving this medication.

F. Blood urea nitrogen 17 mg/dL (6.07 mmol/L): A normal BUN level suggests that renal function is adequate. Since vancomycin is primarily excreted by the kidneys, good renal function supports safe medication clearance and reduces toxicity risk.

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The healthcare provider (HCP) prescribes pantoprazole for a client who experienced partial and full thickness burns. The client is questioning the nurse if this medication is necessary. Which action(s) should the nurse implement? Select all that apply.

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A client with Parkinson's disease who is taking carbidopa/levodopa reports the urine appears to be darker in color. Which action should the nurse take?

Correct Answer is B

Explanation

Patient Data Exhibits The nurse is preparing the client's plan of care (POC). Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.

Correct Answer is ["A","D","E","F"]

Explanation

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