The nurse identifies the client exhibiting supraventricular tachycardia and calls the provider. Several orders are given. For which of the following orders would the nurse request further clarification? (Select all that apply)

Place defibrillator pads and prepare for defibrillation

Prepare Cardizem subcutaneously

Prepare for synchronized cardioversion

Prepare Adenosine PO

Prepare for Adenosine IV

Answer and Explanation

Correct Answer : A,B,D

Choice A reason: Placing defibrillator pads and preparing for defibrillation is typically not indicated for supraventricular tachycardia (SVT) unless the patient is unresponsive or pulseless, which requires immediate emergency intervention. SVT is usually managed with vagal maneuvers or medications.

Choice B reason: Cardizem (diltiazem) is not administered subcutaneously. It is usually given orally or intravenously for the treatment of arrhythmias. Requesting clarification on this order is necessary to ensure the correct administration route.

Choice C reason: Preparing for synchronized cardioversion is an appropriate order for the treatment of unstable SVT if medications are ineffective. This procedure involves delivering a timed electrical shock to restore normal heart rhythm.

Choice D reason: Adenosine is not administered orally. It is typically given as a rapid intravenous push to treat SVT. Preparing adenosine for oral administration is incorrect and requires clarification to ensure the patient's safety and effective treatment.

Choice E reason: Preparing for adenosine IV is appropriate as it is the correct route of administration for treating SVT.

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Correct Answer is A

Explanation

Choice A reason: A headache is a common and expected side effect of nitroglycerin. Nitroglycerin causes vasodilation, which can lead to increased blood flow to the head and result in headaches. It is important to inform the client that this is a known side effect and to manage it with appropriate measures, such as taking analgesics.

Choice B reason: An allergic reaction to nitroglycerin would typically present with symptoms such as rash, itching, swelling, or difficulty breathing. A headache alone does not indicate an allergic reaction.

Choice C reason: A headache does not mean the medication should not be used again. It is a common side effect, and the benefits of nitroglycerin in relieving chest pain usually outweigh the discomfort of the headache. The nurse should educate the client on managing the headache while continuing the medication.

Choice D reason: A headache is not an indication of a worsening cardiac condition. It is a common side effect of the vasodilatory effects of nitroglycerin.

A. Increased urinary output B. Hyperactive bowel sounds C. Abdominal tenderness/pain D. Bradycardia

Correct Answer is C

Explanation

Choice A reason: Increased urinary output is not a manifestation of peritonitis. Peritonitis affects the peritoneal cavity, leading to abdominal symptoms rather than changes in urinary output.

Choice B reason: Hyperactive bowel sounds can occur in various gastrointestinal conditions but are not specific to peritonitis. Peritonitis typically presents with abdominal pain and tenderness.

Choice C reason: Abdominal tenderness/pain is a key manifestation of peritonitis. Inflammation of the peritoneum causes significant discomfort, and patients may also exhibit signs of infection such as fever and increased white blood cell count.

Choice D reason: Bradycardia is not commonly associated with peritonitis. Peritonitis primarily affects the abdominal cavity and may lead to systemic symptoms like fever and tachycardia, but not typically bradycardia.

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The nurse identifies the client exhibiting supraventricular tachycardia and calls the provider. Several orders are given. For which of the following orders would the nurse request further clarification? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client newly diagnosed with angina pectoris has taken two sublingual nitroglycerin tablets for chest pain. The chest pain is relieved, but the client now reports a headache. The nurse interprets that this most likely represents which response?

Correct Answer is A

Explanation

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which manifestations of peritonitis?

Correct Answer is C

Explanation

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