The physician orders strict I & O for a critically ill patient with CHF on a furosemide drip.
The RN knows that it would be appropriate to ask the physician for an order to place a Foley catheter for this patient.

Choice A rationale

Biologic response modifiers are primarily used for autoimmune diseases like rheumatoid arthritis due to their ability to target specific components of the immune system. They are not standard for osteoarthritis, as OA is a degenerative joint disease without a significant autoimmune component. These treatments do not address the inflammation or pain related to OA effectively.

Choice B rationale

Opiates are used for severe, short-term pain management but carry risks such as addiction and tolerance. They do not address the underlying inflammation in osteoarthritis. Long-term use is generally avoided for OA as safer options like NSAIDs are more effective for managing chronic symptoms without these risks.

Choice C rationale

Disease-Modifying Antirheumatic Drugs (DMARDs) are more effective for autoimmune conditions like rheumatoid arthritis, not osteoarthritis. OA lacks the autoimmune pathology targeted by DMARDs, making them unsuitable for managing OA symptoms like pain or stiffness.

Choice D rationale

NSAIDs are the first-line therapy for OA as they effectively reduce both inflammation and pain associated with the condition. By inhibiting cyclooxygenase enzymes, NSAIDs decrease prostaglandin production, leading to improved joint function and symptom control, making them the most common choice for OA symptom management.

Choice A rationale

Staying with the patient and rechecking blood glucose delays immediate corrective action required for severe hypoglycemia (40 mg/dL). While safety is important, prompt treatment with glucose is the priority to prevent further complications.

Choice B rationale

Following the hypoglycemia protocol ensures immediate glucose administration, either orally, intravenously, or intramuscularly, to stabilize the patient. This is critical as glucose levels below 40 mg/dL require urgent intervention to prevent neuronal damage or coma.

Choice C rationale

Monitoring and rechecking glucose after treating is essential but not sufficient as the first action. Hypoglycemia this severe needs immediate treatment before monitoring, ensuring prompt glucose replacement to prevent worsening symptoms.

Choice D rationale

Notifying the physician without treating the hypoglycemia risks unnecessary delays. Immediate action, such as administering glucose per protocol, is vital in this emergency scenario for patient safety.