The nurse identifies several problems for an older adult client experiencing diarrhea and fecal incontinence who is confined to bed and being cared for by a primary caregiver. In planning care, the nurse should determine which nursing problem is the highest priority?

Fluid volume deficit.

Caregiver role strain.

Bowel incontinence.

Impaired bed mobility.

Answer and Explanation

The Correct Answer is A

A.   Diarrhea can lead to significant fluid and electrolyte imbalances, especially in older adults. Prioritizing hydration and electrolyte management is essential to prevent severe complications like renal failure or shock.
B.   While caregiver stress is significant and must be addressed, it is not as immediately life-threatening as a fluid volume deficit.
C.   This is an ongoing management issue but does not pose an immediate threat to the client's life compared to fluid and electrolyte imbalances.
D.   Although important for overall care and prevention of complications such as pressure ulcers, it is not as critical as managing fluid volume deficit in this scenario.

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Correct Answer is D

Explanation

A: Osmolality measures the concentration of solutes in the blood and is not typically affected by naproxen or indicative of the reported symptoms.

B: While naproxen can cause gastrointestinal irritation and ulceration, it does not typically affect serum calcium levels. Monitoring serum calcium would not directly address the client's reported symptoms.

C: ESR is a nonspecific marker of inflammation and is not directly related to the reported symptoms of stomach pain, weakness, and fatigue associated with naproxen use.

D: Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), can cause gastrointestinal bleeding, which may lead to anemia and a decrease in hemoglobin levels. Monitoring hemoglobin levels can help assess for gastrointestinal bleeding in this client who is experiencing stomach pain and weakness/fatigue.

A. Call the healthcare provider and clarify the prescription. B. Request verification of the prescription by the charge nurse. C. Tell the pharmacy to send an accurate child's dosage. D. Ask another nurse if adult dosages are ever given to children.

Correct Answer is A

Explanation

A. If the PN suspects an error in a prescription, especially regarding a child's dosage, it's imperative to communicate concerns to the healthcare provider for clarification and potential adjustment.
B. While involving another nurse might provide a second opinion, it's crucial to involve the prescriber to rectify any potential prescription errors.
C. The prescription should be confirmed with the healthcare provider before any medication is dispensed or administered.
D. While seeking information from peers is valuable, this situation calls for direct clarification from the prescriber to ensure proper dosing for the child.

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The nurse identifies several problems for an older adult client experiencing diarrhea and fecal incontinence who is confined to bed and being cared for by a primary caregiver. In planning care, the nurse should determine which nursing problem is the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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