A patient diagnosed with depression tells the nurse, "I've been supplementing my paroxetine (Paxil) with St. John's wort, and it has helped a great deal." What is the nurse's priority action?
a. Assess changes in the patient's level of depression.
b. Remind the patient to use a secondary form of birth control.
c. Educate the patient about the risks of serotonin syndrome.
d. Suggest adding valerian to the treatment regimen to further improve results.
C
Research has suggested that St. John's wort inhibits serotonin reuptake by elevating extracellular sodium; thus it may interact with medication, particularly selective serotonin reuptake inhibitors, to produce serotonin syndrome. Discussing the patient's birth control method is a secondary priority.
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The family of an older patient dying of liver cancer is concerned that the patient will not eat or drink. The patient is alert and oriented, and expresses no desire to eat. What action would the nurse take?
1. Force fluids. 2. Consult the dietician for feeding supplements. 3. Contact the physician for an order for tube feedings. 4. Comply with the patient's wishes despite the family's concern.
The nurse teaching a client about continuous ambulatory peritoneal dialysis (CAPD) would include the information that
a. a small, lightweight pump must be carried in a pocket or on a belt. b. CAPD eliminates the need for strict aseptic technique when handling the catheter. c. the procedure involves instilling 250 to 500 ml of fluid at a time. d. there are four daily cycles with an 8-hour dwell for one cycle during the night.
Which of the following is a developmental task of middle adulthood?
a. Developing friendships b. Adjusting to physical changes c. Selecting a partner d. Developing a satisfactory sex life
The parent of a 4-year-old brings the child to the clinic and tells the nurse the child's abdomen is distended. After a complete examination, a diagnosis of Wilms tumor is suspected. Which of the following is most important when doing a physical examination on this child?
1. Avoid palpation of the abdomen. 2. Assess the urine for the presence of blood. 3. Monitor vital signs, especially the blood pressure. 4. Obtain an accurate height and weight.