The patient has an order for Percocet 2 tabs qh prn for pain.

Based on the label below, if the patient takes 2 tabs every 6 hours, how much acetaminophen will the patient take in 24 hours? 

Choice A rationale

"Impaired tissue integrity" is a broad term that could apply to many conditions. However, "related to epidermal shedding" is not a precise or accurate description of the underlying pathophysiology of psoriasis. Psoriasis is a hyperproliferative disorder where the skin cells grow too quickly, leading to the accumulation of scales, not just shedding. The primary problem is the creation of new, abnormal tissue, not just the shedding of old.

Choice B rationale

While anxiety is a common psychological response to a chronic skin condition like psoriasis, the specific risk for melanoma is not a direct concern for a patient with psoriasis itself. Psoriasis does not increase the risk for melanoma. However, some treatments for psoriasis, like phototherapy, can increase the risk of non-melanoma skin cancers.

Choice C rationale

Acute pain related to blistering and erosions of the oral cavity is a more appropriate diagnosis for conditions like pemphigus vulgaris or Stevens-Johnson syndrome, which are autoimmune blistering disorders. Psoriasis does not typically involve the formation of blisters or erosions in the oral cavity. The primary symptoms are plaques and scales, and pain is not usually a prominent feature unless the skin is cracked.

Choice D rationale

"Impaired skin integrity related to scaly lesions" is a highly appropriate nursing diagnosis for a patient with psoriasis. The scaly plaques directly represent a disruption in the skin's normal protective barrier. This diagnosis accurately reflects the physical manifestations of the disease and allows for the development of interventions aimed at restoring and maintaining the integrity of the skin's surface. *.

Choice A rationale

Occasional expiratory wheezes can be a sign of bronchoconstriction but do not necessarily indicate a need for immediate suctioning. Suctioning is primarily indicated for the presence of secretions that obstruct the airway, not for bronchospasm, which is typically treated with bronchodilators.

Choice B rationale

Suctioning is a procedure based on patient assessment findings, not a predetermined schedule. Performing the procedure on a timed basis, without clinical indication, can cause trauma to the tracheal and bronchial mucosa, increasing the risk of infection and bleeding.

Choice C rationale

A pulse oximeter reading of 93% is within the acceptable range for many patients and does not, by itself, indicate the need for suctioning. The need for suctioning is based on the presence of secretions, not solely on oxygen saturation levels, unless there is a significant drop in SpO$_2$.

Choice D rationale

A respiratory rate of 32 breaths/min indicates increased respiratory effort and distress. This tachypnea may be a sign of airway obstruction from secretions, which the patient is trying to clear. The nurse should perform an assessment, including auscultation, and consider suctioning. *.