You are caring for a patient post-op after bariatric surgery. Complete the sentence using the drop-down choices.
The nurse knows that the patient needs to ambulate post-op for several reasons.
This can help the patient dropdown as well as help prevent dropdown and dropdown
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A","dropdown-group-3":"A"}
A. A single IV line allows simultaneous administration of multiple drugs, but compatibility must be confirmed. Morphine and ketorolac are generally compatible for IV administration, but a dedicated line is preferred to avoid potential precipitation or chemical interactions that could reduce efficacy or cause harm. A dedicated line ensures each drug is delivered without interference, aligning with safe administration practices for this patient’s pain management.
B. A Y-site IV configuration allows drugs to mix at the infusion site, which could lead to incompatibility. Morphine, an opioid, and ketorolac, an NSAID, have different chemical properties, and while no major incompatibility is documented, using a Y-site risks minor interactions or reduced efficacy, making it less ideal than a dedicated line for this patient.
C. Flushing the IV line ensures patency but does not address drug compatibility. Morphine and ketorolac administration through the same line without a dedicated setup could lead to precipitation or reduced effectiveness, especially if not flushed properly between doses. This option is insufficient for ensuring safe delivery in this context.
D. Ketorolac, an NSAID, can cause gastrointestinal or renal side effects but does not directly interfere with morphine’s action. However, simultaneous administration through the same IV line could risk chemical incompatibility, such as precipitation, which could obstruct the line or reduce drug efficacy, making this a critical consideration for the patient’s IV setup.
E. Morphine, an opioid, provides analgesia but does not inherently interfere with ketorolac’s action. The concern lies in their co-administration through the same IV line, where potential chemical interactions could occur, supporting the need for a dedicated line to ensure both drugs are delivered effectively for the patient’s pain control.
F. Heparin, an anticoagulant, is not mentioned in the provider’s orders. Interference with heparin is irrelevant here, as the focus is on morphine and ketorolac compatibility. This option is incorrect, as it does not address the patient’s medication regimen or IV administration concerns.
G. Saline is used for flushing IV lines to maintain patency, not as a primary drug. It does not interfere with morphine or ketorolac but is irrelevant to the question of drug interference, making this option incorrect for the patient’s pain management context.
H. Precipitation occurs when incompatible drugs mix, forming insoluble particles that can clog the IV line or reduce drug efficacy. Morphine and ketorolac have a low risk of precipitation, but a dedicated line minimizes this risk, ensuring safe and effective delivery, making this a correct consideration for the patient’s IV setup.
I. Flushing between drug administrations prevents mixing but does not eliminate the need for a dedicated line. While flushing reduces interaction risks, it is less reliable than a dedicated line for ensuring morphine and ketorolac are administered without interference, making this option less optimal for the patient’s needs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Omeprazole, a proton pump inhibitor, reduces gastric acid production by irreversibly inhibiting the H+/K+-ATPase enzyme in parietal cells. This decreases acid-related damage to the gastric mucosa, promoting healing of peptic ulcers. It is highly effective for H. pylori-associated ulcers when combined with antibiotics, making it a standard choice for peptic ulcer treatment.
Choice B reason: Ranitidine, an H2 receptor antagonist, reduces acid secretion by blocking histamine receptors on parietal cells. While effective for mild ulcers, it is less potent than proton pump inhibitors like omeprazole for severe cases or H. pylori-related ulcers. It is not the first-line choice for peptic ulcer disease in most modern treatment protocols.
Choice C reason: Sucralfate forms a protective barrier over the ulcer, shielding it from acid and pepsin, promoting healing. It does not reduce acid production, unlike proton pump inhibitors. While useful as an adjunct, it is not a proton pump inhibitor, so it would not be the anticipated medication in this context.
Choice D reason: Metronidazole is an antibiotic used in H. pylori eradication regimens, often combined with proton pump inhibitors and other antibiotics. It does not reduce gastric acid or directly treat ulcers. Its role is to eliminate bacterial infection, not to inhibit acid production, so it is not classified as a proton pump inhibitor.
Correct Answer is A
Explanation
Choice A reason: Impaired gas exchange is the highest priority in Pneumocystis carinii pneumonia (now Pneumocystis jirovecii pneumonia). This opportunistic infection causes alveolar inflammation, reducing oxygen diffusion across the alveolar-capillary membrane. Hypoxemia results, impairing tissue oxygenation. Prioritizing gas exchange ensures adequate oxygen delivery to vital organs, addressing the life-threatening nature of this respiratory infection.
Choice B reason: Activity intolerance occurs in Pneumocystis pneumonia due to hypoxemia and fatigue from infection. While significant, it is secondary to impaired gas exchange, as oxygen delivery is critical for survival. Addressing hypoxemia through oxygen therapy or ventilation support takes precedence, as it directly impacts the patient’s ability to sustain physical activity.
Choice C reason: Imbalanced nutrition: less than body requirements may occur due to increased metabolic demands or poor appetite in Pneumocystis pneumonia. However, it is not the highest priority, as nutritional deficits are less immediately life-threatening than hypoxemia. Correcting gas exchange ensures oxygenation, which supports metabolic processes before addressing long-term nutritional needs.
Choice D reason: Impaired oral mucous membranes may result from opportunistic infections or treatment side effects in Pneumocystis pneumonia. While uncomfortable, it is not life-threatening compared to impaired gas exchange, which causes hypoxemia and risks organ failure. Addressing respiratory function is critical before managing secondary issues like oral health in this acute infection.
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