The nurse is performing a physical assessment on a patient who is receiving treatment with abacavir, zidovudine, and lamivudine [Trizivir]. The patient complains of fatigue
Upon further assessment, the nurse finds a rash and notes that the patient has a temperature of 101.1°F. What is the nurse's best course of action? a. Tell the patient that this is an expected response to these medications and to con-tinue the agents as prescribed.
b. Have the patient hold the medications and arrange for an immediate evaluation by the prescriber.
c. Have the patient continue the abacavir but discontinue the other two agents for 3 weeks.
d. Instruct the patient to continue all three medications and administer an antihista-mine for the symptoms.
B
The patient should discontinue all the medications. Immediate assessment by the provider is re-quired, because the patient is showing early symptoms of a fatal hypersensitivity reaction. This is not an expected response; it indicates a serious reaction, which the patient should report to the prescriber immediately. The patient should not continue the medications for any additional do-sages.
You might also like to view...
State Death with Dignity Laws require that the terminally ill client be:
a. educated regarding treatment alternatives. b. over the age of 55 c. be supported in their decision by immediate family members d. eligible for federal support services
The nurse works in an emergency department in a town with a large proportion of retired persons. The nurse should consider which difference between older and younger adults as it pertains to emergency care?
1. Younger patients are at greater risk for rib fractures and flail chest because their chests are not as compliant as those of older adults. 2. Older patients have a greater capacity to increase their cardiac output on demand, and therefore can tolerate greater blood loss than younger patients. 3. Older patients have an increased incidence of subdural hematomas because their veins are more fragile and less elastic compared to those of younger patients. 4. The aorta is comparatively closer to the surface in younger adults, so they are at greater risk of tearing injuries.
During the nurse's assessment of a new patient on a medical unit, the patient confides in the nurse that her husband often "slaps me around" after he has been drinking. What action should the nurse take in response to this statement?
A) Ask the patient to write down descriptions of these instances and make these documents part of the patient's medical record. B) Discuss with the patient the possible triggers that set off her husband's behavior. C) Report the patient's statement promptly to the appropriate authorities. D) Elicit further detail from the patient to determine the validity of her accusation.
When shaving a patient's beard, you should shave in which direction to avoid ingrown hairs?
A) opposite direction in which the hairs grow B) across the pattern of growth C) in the same direction that the hairs grow D) any of the above