Which outcome should a nurse establish as a priority for a patient taking an oral glucocorticoid for long-term treatment of asthma?
A. Increases the daily intake of vitamin D and calcium
B. Records daily peak expiratory flow rates
C. Supplements additional doses at times of stress
D. Uses alternate-day therapy to reduce adverse effects
Ans: C. Supplements additional doses at times of stress
Adrenal suppression can be profound with oral glucocorticoid use. It is a priority that patients take supplemental oral or intravenous doses at times of stress; failure to do so can be fatal. Alternate-day dosing, using a peak flowmeter, and minimizing bone loss with vitamin D and calcium intake are important; however, they are not as important as supplemental doses of glucocorticoid at times of stress.
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Nursing care, no matter where it is delivered, has many consistencies. One of these consistencies is the need for what?
A) Advanced education B) Certification in a specialty C) Cultural competence D) Independent practice
After completing an assessment, the nurse is concerned that a middle-aged patient is at risk for having a chronic illness later in life. What did the nurse assess in this patient? Select all that apply.
1. Has a blood pressure reading of 150/90 2. Goes out with friends for a drink once per week 3. Smokes 1 pack of cigarettes per day for the last 25 years 4. Has a history of lower back pain 5. Works as a laboratory technologist
A patient calls the nurse to report that she forgot to take a combination OC pill during the third week of her cycle. She tells the nurse that she missed another pill earlier that week. The nurse will tell her to:
a. continue the pack, skip the inert pills, and use an additional form of contraception for 7 days. b. not to worry, because up to 7 days can be missed without an increased risk of preg-nancy. c. take a pill immediately, continue the pack, and use an additional form of contracep-tion for 1 month. d. take a pill now, continue the pack, skip the placebo pills, and start a new pack on week 4.
A patient with atrial fibrillation is receiving warfarin [Coumadin]. The nurse notes that the patient's INR is 2.7 . Before giving the next dose of warfarin, the nurse will notify the provider and:
a. administer the dose as ordered. b. request an order to decrease the dose. c. request an order to give vitamin K (phy-tonadione). d. request an order to increase the dose.