Your client is complaining of "sudden, crushing chest pressure", and is having difficulty breathing.
Her physician has ordered a STAT dose of nitroglycerin. When should you administer the medication?
On an as needed basis.
On a prescribed schedule.
At the earliest convenience.
Immediately.
The Correct Answer is D
Choice A rationale
Administering nitroglycerin on an as-needed basis for sudden, crushing chest pain is inappropriate because the immediate nature of the pain requires rapid intervention. Myocardial ischemia, often causing such pain, necessitates swift vasodilation to improve coronary blood flow and oxygen supply, preventing irreversible cardiac muscle damage. Delay can exacerbate ischemia.
Choice B rationale
Administering nitroglycerin on a prescribed schedule is typically reserved for prophylactic use in conditions like stable angina to prevent episodes, not for acute, sudden onset chest pain. This type of pain indicates an acute event, potentially myocardial infarction, demanding immediate action to mitigate cardiac damage through rapid vasodilation.
Choice C rationale
Administering medication at the earliest convenience is not appropriate for a STAT order in a patient experiencing sudden, crushing chest pain. "STAT" signifies an urgent need for the medication, indicating a life-threatening or rapidly evolving condition requiring immediate pharmacological intervention to avert significant physiological compromise.
Choice D rationale
Administering nitroglycerin immediately is crucial for sudden, crushing chest pain as it suggests acute myocardial ischemia or infarction. Nitroglycerin causes vasodilation, reducing preload and afterload, which decreases myocardial oxygen demand and improves coronary blood flow, thereby limiting cardiac damage and alleviating symptoms rapidly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Using a large bore needle (e.g., 18-gauge) for withdrawing medication from an ampule is generally avoided unless the medication is highly viscous, because it can create a larger hole in the ampule, increasing the risk of glass particle introduction. The primary concern with ampules is preventing glass shards from entering the syringe, which is addressed by filtration, not needle bore size alone.
Choice B rationale
Ampules are single-dose glass containers. When an ampule is opened, small, invisible glass fragments can break off. A filter needle contains a microscopic filter that traps these glass particles, preventing their aspiration into the syringe and subsequent injection into the patient, thus mitigating the risk of phlebitis, emboli, or other complications from particulate matter.
Choice C rationale
A small gauge needle (e.g., 25-gauge) has a very narrow lumen, which would make withdrawing medication from an ampule unnecessarily difficult and slow, especially for viscous solutions. Furthermore, a small gauge needle does not mitigate the risk of glass particle aspiration, which is the paramount concern when withdrawing medication from a glass ampule.
Choice D rationale
Placing a cotton ball over the opening of an ampule is not a scientifically sound method to prevent being cut or to prevent glass shards from entering the medication. Ampules are designed to be broken cleanly. Proper ampule opening techniques and the use of a filter needle are the established safety measures to prevent injury and contamination.
Correct Answer is ["3"]
Explanation
LABEL #3 - LEVOXYL states that one tablet contains 0.1 mg of levothyroxine.
Step 1 is to determine the dose per tablet. 0.1 mg/tablet.
Step 2 is to calculate the number of tablets to administer. 0.3 mg ÷ (0.1 mg/tablet) = 3 tablets. The final calculated answer is 3 tablets.
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