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: Norepinephrine is a vasopressor used to treat septic shock from a wound infection, which causes vasodilation and hypotension. By stimulating alpha-adrenergic receptors, it increases vascular tone, raising blood pressure to improve tissue perfusion. The client’s severe hypotension (78/50 mm Hg) and tachycardia (136 bpm) indicate shock, making norepinephrine an appropriate choice to stabilize hemodynamics.
Choice B reason: Vancomycin treats infections like those caused by methicillin-resistant Staphylococcus aureus, common in wound infections. However, it does not address the client’s immediate hypotension and tachycardia, which indicate septic shock. Antibiotics are crucial for infection source control but do not rapidly correct hemodynamic instability, so this is not the primary order expected now.
Choice C reason: Furosemide, a diuretic, promotes urine output and is used in fluid overload conditions like heart failure. In septic shock with hypotension (78/50 mm Hg), it would worsen hypovolemia by reducing intravascular volume, further decreasing blood pressure and perfusion. This is contraindicated in this scenario, as fluid retention is not the primary issue.
Choice D reason: Dopamine, at 5 mcg/kg/min, primarily enhances cardiac output and renal perfusion but has less potent vasopressor effects than norepinephrine. In septic shock with profound hypotension, norepinephrine is preferred for its stronger vasoconstrictive action to restore blood pressure. Dopamine may be used but is less effective for this client’s severe hemodynamic instability.
Correct Answer is ["A","B","G"]
Explanation
A. Antiretroviral therapy (ART), including dolutegravir and lamivudine, inhibits HIV replication, reducing viral load to undetectable levels, which is a primary goal of treatment. This aligns with the patient’s regimen, as suppressing viral load prevents disease progression and reduces transmission risk.
B. Dolutegravir and lamivudine can cause side effects such as headache, nausea, vomiting, and anorexia, which are well-documented in clinical data. Educating the patient about these potential effects is crucial for adherence and managing expectations.
C. ART does not have zero side effects. Clinical evidence shows dolutegravir and lamivudine can cause adverse effects, including gastrointestinal issues and, rarely, liver problems, making this statement incorrect for patient education.
D. While dolutegravir may cause insomnia in some patients, it is not a universal effect requiring nighttime dosing. The prescribed morning dose of dolutegravir is standard to optimize adherence and efficacy, making this statement incorrect.
E. Doubling a missed dose is incorrect and potentially harmful. ART regimens require consistent dosing; patients should take the missed dose as soon as remembered unless it’s close to the next dose, to avoid toxicity and maintain efficacy.
F. Taking ART with antacids is not recommended, as antacids can reduce dolutegravir absorption, decreasing its effectiveness. Patients should be advised to avoid antacids or follow specific timing guidelines, making this statement incorrect.
G. CD4+T cell counts are a key measure of ART effectiveness, as they reflect immune system recovery. Monitoring CD4+T counts every 3 months, as ordered, assesses treatment success, making this statement correct for patient education.
H. ART, including dolutegravir and lamivudine, does not cause wasting syndrome. Wasting syndrome is associated with untreated HIV or older regimens, not modern ART, making this statement incorrect for patient education.
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