The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

Hold the dose and notify the pharmacy to stop dispensing the next premixed doses.

Hold the dose and notify the healthcare provider of the changes in the laboratory studies.

Begin the infusion and monitor the client's bl’od urea nitrogen (BUN), serum creatinine, and liver function tests.

Begin the infusion and submit a drug reaction report to the nursing supervisor.

Answer and Explanation

The Correct Answer is B

A) Hold the dose and notify the pharmacy to stop dispensing the next premixed doses: This action may prevent further administration of fluconazole, but it does not address the underlying concern of rising liver enzyme levels. Holding the dose and notifying the healthcare provider directly would be more appropriate.

B) Hold the dose and notify the healthcare provider of the changes in the laboratory studies: This is the correct response. RisIng liver enzyme levels, indIcated by an increasing trend in aspartate aminotransferase (AST), suggest potential liver dysfunction or damage, which can be a serious adverse effect of fluconazole. The nurse should hold the dose and promptly inform the healthcare provider for further evaluation and management.

C) Begin the infusion and monitor the client's bl’od urea nitrogen (BUN), serum creatinine, and liver function tests: Initiating the infusion without addressing the rising liver enzyme levels could potentially worsen liver function. It is essential to hold the dose and inform the healthcare provider before proceeding with further administration.

D) Begin the infusion and submit a drug reaction report to the nursing supervisor: While it's im’ortant to document adverse reactions and submit reports as appropriate, the priority in this situation is to hold the dose and notify the healthcare provider to address the rising liver enzyme levels.

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Correct Answer is ["133"]

Explanation

The nurse should program the infusion pump to deliver approximately 133 ml/hour.

Here's how we can calculate the rate:

Total volume of infusion (mL): 200 mL (dextrose 5% in water)

Infusion time (minutes): 90 minutes

We need to convert the infusion time to hours for the pump rate calculation:

Infusion time (hours) = 90 minutes / 60 minutes/hour

Infusion time (hours) = 1.5 hours

Now, calculate the flow rate (mL/hr):

Flow rate (mL/hr) = Total volume (mL) / Infusion time (hours)

Flow rate (mL/hr) = 200 mL / 1.5 hours

Flow rate (mL/hr) = 133.33 mL/hr (round to nearest whole number as requested)

Therefore, the nurse should program the pump to deliver 133 ml/hour.

A. Evaluate the client's ability to recognize the urge to defecate. B. Determine the frequency and consistency of bowel movements. C. Observe the skin integrity of the client's rectal and sacral areas. D. Assess the client's strength in moving and turning in the bed.

Correct Answer is B

Explanation

A) Evaluate the client's ability to recognize the urge to defecate: Assessing the client's ability to recognize the urge to defecate is important for promoting independence in toileting. However, this assessment may not directly indicate the need for administering a laxative. It is more relevant for clients who are able to ambulate or have control over their bowel movements.

B) Determine the frequency and consistency of bowel movements: Assessing the frequency and consistency of bowel movements provides valuable information about the client's bowel function and helps determine the need for a laxative. It allows the nurse to establish a baseline and evaluate the effectiveness of interventions. Understanding the client's typical bowel pattern is crucial before administering a laxative to avoid overmedication or potential complications such as diarrhea or fecal impaction.

C) Observe the skin integrity of the client's rectal and sacral areas: Assessing skin integrity in the rectal and sacral areas is crucial for preventing pressure ulcers, especially in bedfast clients. However, it is not directly related to the need for administering a laxative.

D) Assess the client's strength in moving and turning in the bed: While assessing the client's strength and mobility is important for overall care and prevention of complications related to immobility, it may not be directly related to the need for administering a laxative. This assessment is more relevant for preventing complications such as pressure ulcers and maintaining musculoskeletal function.

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The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["133"]

Explanation

Before administering a laxative to a bedfast client, it is most important for the nurse to perform which assessment?

Correct Answer is B

Explanation

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The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

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