ATI Capstone Responses

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1. A client is receiving home oxygen. What teaching points should the nurse provide the client and the caregiver regarding home oxygen safety? Instructed patient / caregiver about a few simple preca... utions that can be taken to create a safe home environment when using oxygen. Post signs in every room where oxygen is in use. Make sure that absolutely no smoking occurs in the home or in the car when oxygen is in use. Secure an oxygen cylinder to a solidly fixed object to avoid creating a missile out of the tank. This might happen if it was accidentally knocked over and gas was allowed to escape. Use caution with oxygen tubing so you do not trip over it or become entangled in furniture. Be familiar with the equipment and the safety checks established by the medical equipment provider. Keep their contact telephone numbers, and the numbers for other emergency services, posted near a phone. Do not try to repair broken equipment on your own. Request this service from the oxygen provider. Make sure smoke detectors in the home are working. Have fresh batteries installed. Perform monthly checks. Have a fire extinguisher available 2. A nurse is teaching a community course in home safety and providing first aid. What instructions should the nurse include for a client that is bleeding? Obtain consent: Tell the person your name, describes type and level of training, states what you think is wrong and what you plans to do, and asks permission to provide care. - Tell a bystander to get the AED and first aid kit: Point to a bystander and speak out loud. - Use appropriate PPE: Put on gloves, if available. 3. What are nursing interventions and appropriate communication techniques to utilize with a client who is anxious? Deep breathing. One of the easiest stress reducing exercises to learn is deep breathing; it's easy to use in any situation. ... Listening to music. Music works as a relaxation method. ... Visualization and redirecting thoughts. ... Mindful movement. ... Play out the scenarios. 4. What actions should be taken by the nurse when caring for a client that has refused prescribed medications? The main reason patients refuse treatment is that they have concerns about it. These concerns can range from not thinking the procedure is necessary, to being afraid that it will kill them. It is important to bring these concerns to light so that you can talk to the patient about them. 5. What are three (3) indications for folic acid therapy? For the treatment of folate deficiency megaloblastic anemia. For the treatment of folate deficiency megaloblastic anemia or macrocytic anemia secondary to folic acid deficiency, hepatic disease, alcoholism, intestinal obstruction, or excessive hemolysis 6. A critical care client has received propranolol to treat supraventricular tachycardia. What are three (3) complications the nurse should monitor for? The more common side effects of propranolol can include: slower heart rate. diarrhea. dry eyes. hair loss. nausea. weakness or tiredness. 7. A nurse is caring for a client with many different medications who is newly prescribed acetazolamide. What medications can interact with acetazolamide? Acetazolamide may interact with cisapride, methenamine, anticonvulsants, other diuretics, cyclosporine, digoxin, drugs for diabetes, drugs that cause loss of potassium, lithium, memantine, procainamide, quinidine, aspirin and other salicylates, sodium bicarbonate, stimulants, or tricyclic antidepressants. 8. A client has been prescribed misoprostol for the treatment of peptic ulcer disease. What is a true contraindication for this medication? Misoprostol is contraindicated during pregnancy for use to reduce the risk of stomach ulcers associated with NSAIDs (the FDA-approved indication). This agent causes reproductive risk, including uterine contractions, miscarriage, and other problems if administered during pregnancy. 9. A client has been prescribed oxybutynin for treatment of overactive bladder and has been experiencing anticholinergic side effects. List two (2) actions the client will take to prevent adverse effects of the medication therapy. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Acid or sour stomach belching decreased sweating diarrhea difficulty having a bowel movement (stool) drowsiness dryness of the eyes, mouth, nose, or throat heartburn indigestion runny nose stomach discomfort, upset, or pain 10. A nurse is preparing to administer acetylcysteine. What are indications for therapy? When inhaled by mouth, acetylcysteine is used to help thin and loosen mucus in the airways due to certain lung diseases (such as emphysema, bronchitis, cystic fibrosis, pneumonia). This effect helps you to clear the mucus from your lungs so that you can breathe easier. 11. A nurse is caring for a client who has a new prescription for alosetron. What are the expected therapeutic effects of this medication? Alosetron blocks the action of a chemical called serotonin in the intestines. This slows the movement of stools (bowel movements) through the intestines. Alosetron is used to treat severe, chronic irritable bowel syndrome (IBS) in women who have had diarrhea as the main symptom for at least 6 months. 12. A nurse is caring for a client with asthma who asks if montelukast sodium can be taken for acute asthma symptoms. When should montelukast sodium be taken? Montelukast is usually taken once a day with or without food. When montelukast is used to treat asthma, it should be taken in the evening. When montelukast is used to prevent breathing difficulties during exercise, it should be taken at least 2 hours before exercise 13. A nurse has provided education to a client who has a new prescription for exenatide. What statements by the client would indicate they understand the instructions? BYETTA (exenatide injection) should be initiated at 5 mcg administered twice daily at any time within the 60-minute period before the morning and evening meals (or before the two main meals of the day, approximately 6 hours or more apart). BYETTA (exenatide injection) should not be administered after a meal. 14. A client with hypertension is prescribed verapamil. What are the three (3) expected outcomes of this medication therapy? Decrease in frequency and severity of anginal attacks. Decrease in need for nitrate therapy. Increase in activity tolerance and sense of well-being. Suppression and prevention of atrial tachyarrhythmias. 15. A client has a new prescription for an albuterol inhaler and a beclomethasone inhaler. What instructions should the nurse include concerning use of these inhalers? A client has a new prescription for an albuterol inhaler and a beclomethasone inhaler. What instructions should the nurse include concerning use of these inhalers? Albuterol should be administered first. It promotes bronchodilatation and enhances absorption of the glucocorticoid 5. 16. A nurse is caring for a client who has a new prescription for raloxifene. What are contraindications for this medication that the nurse should discuss with the client? Contraindications: pregnancy, history of venous thromboembolism, stop 3 days before period. 17. A client receiving the chemotherapeutic agent, leuprolide for treatment of prostate cancer. What is one (1) important point to discuss with the client to prevent musculoskeletal complications. Important things to remember about the side effects of leuprolide: Most people do not experience all of the side effects listed. Side effects are often predictable in terms of their onset and duration. Side effects are almost always reversible and will go away after treatment is complete. There are many options to help minimize or prevent side effects. There is no relationship between the presence or severity of side effects and the effectiveness of the medication. The following side effects are common (occurring in greater than 30%) for patients taking leuprolide: Hot flashes (see sexuality) Loss of interest in sex (decreased libido) (see sexuality) Inability to obtain or sustain an erection (impotence) (see sexuality) 18. A nurse has an order to administer mannitol to a critical care client. What should the nurse expect following mannitol administration? A normal kidney function as well as a decrease in intracranial pressure and intraocular pressure. This happens due to this drug pooling the fluid out of the extravascular space and placing it back in to the bloodstream. 19. The nurse is caring for a client who has developed malignant hyperthermia. Identify three (3) priority actions the surgical team will need to implement. The surgical team will administer oxygen at 100%, Initiate cooling measures including administration of iced 0.9% sodium chloride, applying a cooling blanket, and placing ice bags in groin and other areas, and administer dantrolene to decrease metabolic activity of skeletal muscle. 20. A client is prescribed topical acyclovir. When teaching a client about application of the medication and management of the infection, what are three (3) points to discuss? Drink 6 to 8 glasses of water or fluids every day while you are taking this medicine. This will hel [Show More]

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