A young client experiences nausea and vomiting after eating peanut butter. Which additional symptom should indicate to the nurse that the client is experiencing an allergic reaction?
a. Hives
b. Diarrhea
c. Constipation
d. Abdominal bloating
a. Hives
Hives, gastrointestinal symptoms, and itching indicate that the client has released histamine because of an immune response and has had an allergic reaction. Food intolerance is associated with abdominal bloating, constipation, diarrhea, and gas production. Food intolerances do not involve an immune system response.
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A nurse cares for a client who possibly has syndrome of inappropriate antidiuretic hormone (SIADH). The client's serum sodium level is 114 mEq/L. Which action should the nurse take first?
a. Consult with the dietitian about increased dietary sodium. b. Restrict the client's fluid intake to 600 mL/day. c. Handle the client gently by using turn sheets for re-positioning. d. Instruct unlicensed assistive personnel to measure intake and output.
The nurse is educating the parents of a 7-year-old boy with asthma about the medications that have been prescribed. Which of the following drugs would the nurse identify as an adjunct to a 2-adrenergic agonist for treatment of bronchospasm?
A) Ipratropium B) Montelukast C) Cromolyn D) Theophylline
A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?
a. Refer him for immediate medical evaluation. b. Administer analgesics and recommend scrotal support. c. Apply an ice bag and observe for increasing pain. d. Reassure the adolescent that occasional pain is common with the changes of puberty.
The discharge summary deals with important elements pertaining to the patient's problems and health care after discharge. When preparing the summary, the nurse needs to include:
A. the specific teaching plan. B. deviations from the plan of care. C. the standardized nursing care plan. D. a detailed description of nursing procedures.