The goal of antibiotic therapy in a patient with sepsis is to narrow the therapy to one narrow-spectrum antibiotic. What purpose does this goal serve in the patient's care and how does it aid in the prevention of antibiotic resistance?
1. The use of one antibiotic ensures that the prescribed dose will result in serum concentrations that are clinically effective.
2. The use of one antibiotic has been shown to cause less organ dysfunction.
3. The use of one antibiotic reduces mortality in patients with sepsis.
4. The use of one antibiotic limits the cost to the patient.
4
Rationale 1: Patients with sepsis have abnormal renal and hepatic function; the pharmacist should be consulted to ensure that the prescribed dose results in serum concentrations that are both clinically effective and minimally toxic.
Rationale 2: The goal is to narrow therapy once culture results identify the infecting organism. This has several benefits, including decreased cost, prevention of the development of resistance, and reduced toxicity.
Rationale 3: This is not a true statement.
Rationale 4: One antibiotic can ultimately reduce the patient's costs but that is not the only purpose of this goal.
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A recently widowed 74-year-old male is seen in the mental health clinic for sleep disorders and depression. Which of the following nursing actions demonstrate caring? (Select all that apply.)
a. Providing a private place to interview the client b. Delegating other tasks to a colleague while speaking to the client c. Addressing the client as "honey" to provide comfort d. Asking about his daily activities and hobbies during the interview e. Listening intently to his responses and not being distracted by his nonverbal communication
The daughter of an older hospitalized patient tells a nurse: "I am worried about my father. His memory is sharper when he is at home. He is forgetful, but is functional. Since he has been hos-pitalized his memory problems are much worse."
The best response by the nurse is: a. "It is common for long-term memory to be more impacted by age-related changes than short-term memory." b. "Memory changes are often worse when an individual is in an unfamiliar or stress-ful situation." c. "Perhaps you are just noticing your fa-ther's memory loss now that he is hospi-talized." d. "There is a lot of new information for your father to process here in the hospital; he is overloaded."
The nurse is teaching childbirth education classes. Teaching has been successful if the primiparous patient states: "I can reduce the likelihood that I'll tear or need an episiotomy if I:
1. "Push in a semi-sitting position." 2. "Make sure I push long and hard." 3. "Begin regular perineal massage." 4. "Pull back on my legs when pushing."
Which intervention would be the best initial approach for a nurse to take when a young adult patient is verbally abusive?
a. Ask the patient to define "verbally abusive language.". b. Provide the patient with examples of assertive communication. c. Identify the patient's verbal abuse in order to set standards for future dialogue. d. Remove privileges from the patient until communications show less aggression.