A 74-year-old client with a history of osteoarthritis is being treated in the hospital for pneumonia and malnutrition. The nurse administered 650 mg of acetaminophen 90 minutes ago and the client is now requesting another dose
The medication administration record has the following choices; which choice by the nurse is most appropriate?
A) Normal saline 5 ml IV
B) Acetaminophen 1,000 mg PO
C) Morphine 5 mg IV
D) Oxycodone 5 mg PO
Ans: D
Limit the amount of acetaminophen to 3,000 mg per day in the client with malnutrition to avoid hepatotoxicity. Pain medication, not normal saline, should be administered. While alternative approaches to pain relief may be warranted, this does not necessarily mean that a pain-controlled analgesia (PCA) was the ideal delivery method. Step 2 of the World Health Organization pain relief ladder suggests adding an opioid. The use of stronger opioids is Step 3.
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Mr. McLeod has been admitted to the postsurgical unit from PACU after a transurethral prostatic resection (TUPR). Mr. McLeod has continuous bladder irrigation running to prevent clotting and his Foley catheter is draining appropriately
His vital signs on admission reveal a blood pressure of 171/ 98 despite the fact that he has no documented history of hypertension. What factor most likely accounts for Mr. McLeod's present increase in blood pressure? A) Mr. McLeod is experiencing a postoperative hemorrhage. B) Mr. McLeod is showing signs and symptoms of malignant hyperthermia. C) Mr. McLeod's sympathetic nervous system is stimulated, possibly by pain. D) Mr. McLeod is fluid overloaded from the intraoperative administration of IV fluids.
The mother of a toddler yells to the nurse, "Help! He is choking to death on his food!" The nurse determines that lifesaving measures are necessary based on which finding?
a. Gagging b. Coughing c. Pulse over 100 beats/min d. Inability to speak
When planning a program to reduce the number of sentinel events in an organization, the program planner should focus on the leading cause of sentinel events, which is related to a problem with:
a. leadership or management. b. staffing patterns. c. environmental safety. d. communication.
The patient is receiving a beta-blocker medication. The nurse has done medication education and provided the patient with printed information to take home
During the next appointment, the nurse notes that the patient is not taking the medication properly. What is a therapeutic assessment question to ask this patient? 1. "Do I have to inform your physician about your noncompliance?" 2. "Why didn't you take your medicine as we talked about?" 3. "Are you able to read and comprehend the printed information?" 4. "Don't you understand how important it is to take the medicine?"