The nurse admits an older adult client and reviews orders from the physician
What order would the nurse question?
? Bedrest with bathroom privileges
? Acetaminophen (Tylenol) 650 mg p.o. every 4 hours p.r.n. pain
? Meperidine (Demerol) 100 mg IM every 6 hours p.r.n. pain
? Zolpidem tartrate (Ambien) 5 mg p.o. p.r.n. HS
1. Bedrest
2. Acetaminophen
3. Meperidine
4. Zolpidem tartrate
3
Rationale: The dosage of meperidine is at the upper limit for a healthy younger adult, but is a very high dosage for an elderly client, and the nurse should question the order. The other orders are appropriate for the older adult.
You might also like to view...
A marathon runner is taken to the emergency department (ED) following a race in which the runner became disoriented, complained of a significant headache, and was dizzy
The client reports drinking several bottles of water immediately following the race. A new ED nurse starts an IV of D5W on this client and the symptoms become worse. Another nurse notices the IV fluids and discusses her concerns regarding the IV fluid with the new nurse. What are the concerns? 1. D5W breaks down into free water when the glucose is metabolized and is increasing the degree of the client's hyponatremia. 2. D5W is the IV fluid of choice and should be infusing at a faster rate. 3. D5W is only given to clients who are admitted to an acute care setting, not those in the ED. 4. D5W increases the sodium for this client too rapidly.
Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include:
1. Older adults and those on fixed incomes 2. Patients with chronic illnesses 3. Patients with copayments for drugs on their insurance 4. Patients on public assistance
A care area has been short staffed for the past month with a heavy client load and high acuity
The nurses have been working extra as well as double shifts and often do not have time to make sure that properly working equipment is cleaned, returned, and stored in the appropriate areas. At what level should this care area be evaluated? 1. Management 2. Structure 3. Process 4. Outcome
The LPN/LVN must be aware that digitalis can cause toxicity; it can also cause hormonal effects in male patients. Which of the following hormonal problems can this medication cause a male patient?
A. increased appetite and weight gain B. swelling in the legs and feet C. gynecomastia and tender breasts D. discoloration around the neck and eyes