A thin older adult woman is admitted to the hospital after several days of vomiting, diarrhea, and poor intake of foods and fluids
She has not voided since admission. In preparing to care for this patient, the nurse will look for what laboratory values to help guide medication administration? (Select all that apply.)
a. Creatinine clearance
b. Gastric pH
c. Plasma drug levels
d. Serum albumin
e. Serum creatinine
ANS: A, C, D
Creatinine clearance is the best way to evaluate renal function in the older adult. Plasma drug levels are important for determining if the patient has toxic or subtherapeutic drug levels. Serum albumin may be decreased, especially in patients who are thin, chronically undernourished, or have been vomiting, and the decreased level may result in higher levels of drugs that normally bind to proteins. Gastric pH is not important; most GI changes result in lowered absorption and less free drug. Serum creatinine levels are related to the amount of lean muscle mass, which may be low in older adult patients, and do not reflect renal function.
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The nurse is classifying a patient's burn injuries. What information should the nurse assess to ensure this classification is correct?
Select all that apply. 1. depth of the burn 2. extent of burns on the body 3. causative agent and duration of exposure 4. location of burns on the body 5. time that the burns occurred
The nurse is conducting a physical examination of a patient's heart. Where will the nurse place the stethoscope to best assess the S1 heart sound?
1. Left midclavicular line at the fifth intercostal space 2. Left sternal border at the fifth intercostal space 3. Right midclavicular line at the fifth intercostal space 4. Right sternal border at the third intercostal space
Which of the following dietary restrictions is indicated with carbamazepine (Tegretol)?
a. Limit foods high in vitamin K. b. Restrict acid-ash foods. c. Maintain a high-fiber diet. d. Do not drink grapefruit juice.
A nursing student evaluates her group project partner as irresponsible because of minimal participation in planning. When told of this situation, the nursing instructor plans to use the cognitive technique of "examining the evidence."
Which response exemplifies this technique? A. "Let's look at the potential reasons why your partner has not participated." B. "How would you define irresponsibility?" C. "Has it occurred to you that your partner may be working on the project at home?" D. "Are you telling me that you feel totally responsible for this project?"