a heat lamp positioned 12 inches from the skin for 10 minutes twice a day antibiotic therapy as ordered increasing the client’s nutritional intake of protein and calories wet to dry dressings once every shift
A child who ingested 18 500-mg acetaminophen tablets 30 minutes ago is seen in the ED. Which of these orders should the nurse do first ?
activated charcoal per pharmacy start an IV with D5W to keep the vein open gastric lavage PRN acetylcysteine (Mucomyst) for age per pharmacy
The nurse is assessing a client who has a sacral pressure ulcer. The wound has partial thickness, loss of dermis and a red-pink wound bed. No slough is present. How would the nurse chart this wound?
Stage I Stage II Stage III Stage IV unstageable
The nurse is preparing to discharge a client diagnosed with gout. Which statement by the client indicates understanding of dietary restrictions while managing gout?
“I should avoid beer, anchovies, and liver.” “I should avoid bananas, grapefruit, and oranges.” “I should avoid dairy products such as milk and ice cream.” “I should avoid red wine, dark chocolate, and aged cheeses.”
The nurse is caring for a client receiving IV vancomycin. The trough level is 14 mcg/mL. The next dose is now due. What is the correct response by the nurse?
give the next dose as ordered wait 2 hours and redraw the trough wait 30 minutes and redraw the trough hold the dose and notify the health care provider
The nurse is caring for a client taking vancomycin. The nurse anticipates drawing a peak and trough on this client. Which statement regarding peak and trough levels is correct?
The peak is drawn 1 hour after the infusion, and the trough is drawn right before the next scheduled dose. The peak is drawn 2 hours after the infusion, and the trough is drawn 1 hour before the next scheduled dose. The peak should be drawn immediately after infusion, and the trough is drawn right…
The nurse is preparing to deliver an infusion of vancomycin through a client’s peripherally inserted central catheter (PICC). Shortly after the infusion begins the IV pumps beeps, indicating a blockage. How should the nurse proceed? Select all that apply.
start a peripheral IV in the opposite limb notify the PICC nurse if unable to clear the blockage use a 5 mL syringe to flush the PICC with sterile saline ask the client to raise and lower the arm or cough attempt to flush the line by aggressively pushing heparin to clear the blockage use…
The nurse is providing discharge teaching to a client newly diagnosed with heart failure. Which statement by the client indicates an understanding of the side effects of furosemide (Lasix)?
“I should eat bananas, dried dates, or peaches every day.” “I should check my heart rate before taking this medicine.” “I will avoid foods containing tyramine while on this medicine.” “I will not take the medicine when I have to go on a long car trip.”
The nurse is precepting a student nurse on the medical-surgical unit. The student nurse is preparing to administer insulin. Which action by the student nurse calls for immediate intervention?
The student nurse verifies the insulin dose with another nurse. The student nurse draws up regular insulin to be given intravenously. The student nurse draws up intermediate-acting (NPH) insulin, and then regular insulin. The student nurse draws up regular insulin, and then intermediate-acting (NPH) insulin.
The nurse is infusing total parenteral nutrition (TPN) through a peripherally inserted central catheter. The client’s TPN was turned off for 1 hour for an MRI. Which action by the nurse is most appropriate for this client?
notify the health care provider for further orders discard the volume of the TPN that should have been administered and make a note in the chart double the flow rate on the infusion for 1 hour to keep the TPN on schedule, and then resume the normal flow rate increase the flow rate on the…