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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","F","H"]
Explanation
A. The site for the insulin administration: While site selection is important for absorption consistency, double-checking the injection site with another nurse is not required under insulin safety protocols. It is an individual nursing responsibility.
B. The insulin vial for color and clarity: Although inspecting insulin for proper color and clarity is critical, it does not formally require double-checking with another nurse. It is part of standard administration checks performed by the individual nurse.
C. The dose of insulin drawn up in the syringe: Double-checking the correct dose with another nurse is essential to prevent dosing errors. Insulin is considered a high-alert medication, and the dose must be verified to ensure client safety.
D. The insulin concentration: Insulin comes in different concentrations (e.g., U-100, U-500). Verifying the concentration with a second nurse is vital to avoid giving the wrong dose based on an incorrect strength.
E. The expiration date on the insulin vial: Checking the expiration date is necessary, but it does not formally require a second nurse verification. It is part of safe medication administration practices.
F. The sliding scale insulin lispro prescription: Ensuring the sliding scale prescription is accurately followed is crucial. Double-checking that the blood glucose reading matches the correct insulin dose according to the sliding scale prevents errors.
G. The history and physical with the diabetes diagnosis listed: Confirming a diagnosis is useful background information but is not necessary to double-check before insulin administration. The medication order itself already assumes the clinical need.
H. The type of insulin to be administered: Verifying that the correct type of insulin (e.g., insulin lispro for rapid-acting) is being used is mandatory. A second nurse must confirm that the right insulin type matches the order to avoid administration mistakes.
Correct Answer is D
Explanation
A. Schedule the medication to be given just before bedtime: Pyridostigmine should be timed to coincide with periods of increased activity, especially before meals, to improve muscle strength. Giving it at bedtime would not offer functional benefit unless the client experiences nighttime symptoms.
B. Break the medication into small pieces and sprinkle onto food: Pyridostigmine tablets are not designed to be crushed or split unless specifically directed. Altering the form may affect its absorption and reduce its effectiveness in managing symptoms of myasthenia gravis.
C. Instruct the client to avoid dairy products for at least 30 minutes: Dairy does not interfere significantly with the absorption or action of pyridostigmine. Dietary restrictions should be based on known drug-food interactions, which are not typically associated with pyridostigmine and dairy.
D. Administer the medication thirty minutes prior to meals: Administering pyridostigmine before meals helps enhance swallowing and chewing abilities, reducing the risk of aspiration. This timing optimizes muscle strength during eating, which is a high-risk activity for clients with myasthenia gravis.
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