A homebound patient drinks a six-pack of beer daily. The patient tells the nurse, "I've been having pain from my arthritis lately, so I take acetaminophen four times a day."
The nurse's priority interventions include: (Select all that apply.)
a. determining the safety of the dose the patient is ingesting daily.
b. inquiring about sleep disturbances caused by mixing alcohol and analgesics.
c. advising the patient of the harmful effect of alcohol and acetaminophen on the liver.
d. suggesting increasing the acetaminophen dose, since alcohol causes faster excretion.
e. assessing for declining functional status associated with medication-induced dementia.
A, C
The nurse should be concerned with the patient's use of alcohol and acetaminophen because the toxicity of acetaminophen is enhanced by alcohol and by the age-related decrease in clearance. The nurse must determine whether the acetaminophen dose is within safe limits or is excessive and provide this information to the patient. Next, the nurse must provide health education regarding the danger of combined use of acetaminophen and alcohol. The patient will likely need to discontinue alcohol or consult the health care provider about another analgesic that is less hepatotoxic. Additional acetaminophen would cause greater liver damage. Dementia is not suggested by the scenario.
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Which change theory is based on beliefs that people are rational and that they will change if it is in their self-interest?
1. Power-coercive 2. Persuasive 3. Empirical-rational 4. Facilitative
A patient who has had a radical neck dissection is being prepared for discharge. The discharge plan includes referral to an outpatient rehabilitation center for physical therapy. What would the goals of physical therapy for this patient include?
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A nurse interviews a pregnant woman regarding health maintenance behaviors. Which comment by the patient would alert the nurse that teaching is needed?
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