Which instruction should the nurse provide an unlicensed assistive personnel (UAP) who is assisting with the personal care of a client receiving clopidogrel?

Maintain a cool, calm room environment.

Provide the client with a soft toothbrush.

Allow the client ample rest periods.

Keep the head of the bed elevated.

Answer and Explanation

The Correct Answer is B

A) Maintain a cool, calm room environment: While a calm environment can be beneficial for overall patient well-being, it is not specifically related to the care of a client on clopidogrel. This instruction does not address the direct needs or precautions associated with clopidogrel use.
B) Provide the client with a soft toothbrush: Clopidogrel is an antiplatelet medication that increases the risk of bleeding. To minimize gum bleeding and oral mucosal damage, it is crucial to use a soft toothbrush to prevent injury. This measure helps to reduce the risk of bleeding complications associated with the medication.
C) Allow the client ample rest periods: While rest is important for overall health, it is not specifically related to the precautions needed for a client on clopidogrel. The primary concern with clopidogrel is managing bleeding risks rather than providing rest.
D) Keep the head of the bed elevated: Elevating the head of the bed is generally useful for managing certain conditions like respiratory issues or gastrointestinal reflux but does not directly relate to the specific needs of a client taking clopidogrel. The focus for clients on clopidogrel should be on preventing bleeding complications.

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Correct Answer is A

Explanation

A. Serum creatinine level of 1.6 mg/dL (141 µmol/L), a blood urea nitrogen (BUN) of 20 mg/dL (7.1 mmol/L): Gentamicin is an aminoglycoside that is known for its nephrotoxic potential. Elevated serum creatinine and BUN levels are indicative of impaired kidney function, which warrants further investigation and possible intervention. This finding is significant because it may reflect kidney damage or reduced renal clearance of the drug.
B. Reports a sore mouth and three episodes of diarrhea that began this morning: While these symptoms are important and could suggest a possible adverse effect or secondary infection, they are not as immediately concerning in the context of gentamicin therapy as the potential for kidney damage indicated by elevated creatinine and BUN levels.
C. White blood count of 9,000/mm³ (9 x 10^9/L) and an oral temperature of 98.2°F (36.7°C) two hours ago: These values are within normal ranges and do not suggest an immediate concern related to gentamicin toxicity.
D. Urinary output of 400 mL of clear, amber-colored urine in the past eight hours: While monitoring urinary output is important, this level of output does not necessarily indicate a problem in the context of gentamicin therapy compared to elevated creatinine and BUN levels.

A. Administer both prescribed medications as scheduled. B. Hold the calcium carbonate, but administer the calcitriol as scheduled. C. Hold the calcitriol, but administer the calcium carbonate as scheduled. D. Hold both medications until contacting the healthcare provider.

Correct Answer is D

Explanation

A. Administer both prescribed medications as scheduled: Given that the client's total calcium level is already elevated (14 mg/dL), administering additional calcium carbonate could exacerbate hypercalcemia. Calcitriol, a form of vitamin D, can also increase calcium levels, so administering it without addressing the high calcium level could worsen the condition.
B. Hold the calcium carbonate, but administer the calcitriol as scheduled: This option is not appropriate because calcitriol can further increase calcium levels, potentially worsening hypercalcemia. Both medications should be reviewed, and their administration should be adjusted according to the client's current calcium status.
C. Hold the calcitriol, but administer the calcium carbonate as scheduled: Holding calcitriol alone would not address the potential for further increasing calcium levels. Calcium carbonate should also be withheld since the client is already hypercalcemic.
D. Hold both medications until contacting the healthcare provider: This is the most appropriate action. The client's elevated calcium level indicates hypercalcemia, which requires careful management. The healthcare provider should be contacted to assess the situation and determine the appropriate course of action to avoid worsening hypercalcemia.

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Which instruction should the nurse provide an unlicensed assistive personnel (UAP) who is assisting with the personal care of a client receiving clopidogrel?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dl (3.5 mmol/l) Which action should the nurse implement? Reference Range: Calcium 8.5 to 10.5 mg/dL (2.25 to 2.75 mmol/L)

Correct Answer is D

Explanation

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