The nurse knows that a patient with a mood disorder who is exhibiting slurred speech and muscle weakness has likely developed which condition?
1. Lithium toxicity
2. Steven-Johnson syndrome
3. Aplastic anemia
4. QT interval prolongation
Answer: 1
Explanation: Lithium is the gold standard for treatment of bipolar disorder, but has a narrow therapeutic index; the ratio between the toxic dose and the therapeutic dose is low, thus increasing the risk for toxicity and side effects such as ataxia, slurred speech, and muscle weakness. Steven-Johnson syndrome is a serious dermatologic reaction that is associated with use of Lamotrigine. Aplastic anemia is associated with carbamazepine use, and QT interval prolongation can occur with the use of atypical antipsychotics.
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While caring for a patient with a pulmonary arterial catheter, the nurse notes that the number of centimeters of exposed catheter has decreased. What nursing action is indicated?
1. Report this finding immediately; the patient may need another chest X-ray to check for placement. 2. Flush the ports. 3. Obtain a pulmonary artery occlusion pressure. 4. Zero balance the system.
The nurse caring for a 1-month-old child with a myelomeningocele will take into consideration when positioning the baby to: (Select all that apply.)
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