What is the highest priority nursing diagnosis for a client with a history of urinary urgency who is taking oxybutynin (Ditropan)?
Risk for impaired urinary elimination
Risk for alteration in body image
Risk for alteration in bowel elimination
Risk for altered comfort: dry mouth
The Correct Answer is D
A. Risk for impaired urinary elimination: Oxybutynin is used to treat urinary urgency, so it is unlikely to impair urinary elimination and may even improve it.
B. Risk for alteration in body image: There is no direct association between oxybutynin use and body image concerns.
C. Risk for alteration in bowel elimination: Oxybutynin can cause constipation, but this is not the highest priority compared to dry mouth.
D. Risk for altered comfort: dry mouth: Dry mouth is a common and bothersome side effect of oxybutynin, making comfort the highest priority concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["50"]
Explanation
Step 1: Calculate the total volume to be infused.
Volume = Rate × Time
Volume = 150 mL/hr × 12 hr = 1800 mL
Step 2: Calculate the total time of infusion in minutes.
Time = 12 hours × 60 minutes/hour = 720 minutes
Step 3: Calculate the drip rate.
Drip rate (gtt/min) = Total volume (mL) / Time (min) × Drop factor (gtt/mL)
Drip rate = 1800 mL / 720 min × 20 gtt/mL
Drip rate = 50 gtt/min
Therefore, the nurse should set the manual IV infusion to deliver 50 gtt/min.
Correct Answer is B
Explanation
A. I will apply a new patch every day to ensure continuous medication levels: This is incorrect. The patch should be changed every 3 to 4 days, not daily.
B. I will apply the patch to my abdomen, hips, or buttocks and change it every 3 to 4 days: This is correct. Transdermal oxybutynin patches should be applied to the specified areas (abdomen, hips, or buttocks) and changed every 3 to 4 days.
C. I will take this medication orally with a full glass of water: This statement is incorrect as it refers to oral oxybutynin, not the transdermal form.
D. I will place the patch on my chest or upper arms for best absorption: This is incorrect as the patch should be placed on the abdomen, hips, or buttocks for optimal absorption.
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