A primary care NP prescribes probenecid to treat a patient who has gout. The patient comes to the clinic 2 weeks later with severe flank pain. The NP should:
a. ask the patient about fluid intake.
b. order a urinalysis and urine culture.
c. change the medication to allopurinol.
d. recommend nonsteroidal antiinflammatory drugs (NSAIDs) to treat flank pain.
A
Uricosuric agents are tubular blocking agents and decrease serum uric acid levels by increasing urinary excretion of uric acid. During this process, high concentrations of uric acid develop in the proximal renal tubules and may predispose the patient to the development of urinary stones. Patients should be encouraged to drink plenty of fluids. The patient who presents with flank pain should be questioned about fluid intake. If fluid intake is sufficient and renal stones are ruled out, a urinary tract infection may be considered. Allopurinol is not indicated. NSAIDs are not indicated.
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You notice that a laboring client's blood pressure is lower when she rests on her back than when she is on her side. This is because
a. she is having back labor b. she is in early labor c. the fetus may compress the major vessels when she is supine d. there is pressure on her arteries in the side-lying position
The nurse giving report tells the next nurse where to find an open bottle of sterile normal saline solution for the client's wound irrigation; then, the nurse finds four bottles labeled with the client's name at the bedside
Which bottle should the nurse use for the client's sterile wound ir-rigation? 1. Label has today's date and time. 2. Label reads, "Use this bottle next.". 3. Label has previous nurse's initials. 4. Saline solution bottle has unbroken seal.
Which option best fulfills the "P" portion of a PICO question?
1. Middle-aged Caucasian men who have been treated for Type I Diabetes Mellitus for over 1 year 2. Infants who are breast-fed 3. Women who are breast cancer survivors 4. African American women who are poor and who have lived in the western United States for some time