A client is receiving amphotericin B IV. The nurse identifies a nursing diagnosis of Impaired Comfort related to medication administration. The nurse determines that the plan of care was effective when which outcome is achieved?

Question

A) Client remains free from rigors.
B) Client exhibits a blood pressure within acceptable parameters.
C) Client maintains a patent IV infusion site.
D) Client maintains a urine output of at least 30 mL/hour.
E) Client demonstrates procedure for cleaning involved area.

Answer 1

Ans: A, B, C
Feedback:
The patient receiving amphotericin B IV can experience rigors, hypotension, and problems with the IV infusion site. Therefore, remaining free from rigors and maintaining a stable blood pressure and a patent IV infusion site would indicate that the plan of care for impaired comfort is successful. A urine output of 30 mL/hour would be an indicator of adequate renal tissue perfusion. Cleaning the involved area would not be appropriate because the client has a systemic fungal infection.