Dec 2018

A client is to receive a transfusion of packed red blood cells (PRBCs). The nurse should prepare for the transfusion by priming the blood IV tubing with which solution

0.9% normal saline

The nurse is measuring the body temperature of four clients in a clinical setting. Which client is in need of rewarming through cardiopulmonary bypass?

85.3F Hypothermia is classified as mild hypothermia (body temperature of 34 °C to 36 °C/93.2 °F to 96.8 °F), moderate hypothermia (body temperature of 30 °C to 34 °C/86 °F to 93 °F), and severe hypothermia (body temperature below 30 °C/86 °F). Client B, with a body temperature of 85.3 °F, is in need of rewarming through cardiopulmonary bypass because his or her body temperature is less than 86 °F. Clients A, C, and D do not have a temperature less than 86 °F; therefore, they may not need rewarming through cardiopulmonary bypass.

what to look for with fluphenazine therapy

Acute dystonic reactions such as tremors, dyskinesia, and akathisia are observable side effects of fluphenazine therapy. There is a decrease, not an increase, in salivation with fluphenazine therapy. Rambling speech is not a side effect of this drug; nor is reluctance to converse

Which antihypertensive drug is contraindicated in lactating women?

Atenolol is contraindicated in lactating woman because it enters the breast milk and may cause adverse effects to the neonate. Labetalol and propranolol are safe to administer during lactation. Metoprolol is a safe drug to be taken during pregnancy.

Drug therapy of muscle spasm

Baclofen (Lioresal) Carisoprodol (soma) Chlorzoxazone Cyclobenzaprine Diazepam (Valium) Metaxalone Usually 3-4 times a day Typically from muscle injury, decreased pain, and increases ROM AE: CNS depression, hepatic toxicity, physical dependence

A nurse is administering medications to clients on a psychiatric unit. What does the nurse identify as the reason that so many psychiatric clients are given the drug benztropine or trihexyphenidyl in conjunction with the phenothiazine-derivative neuroleptic medications?

Benztropine and trihexyphenidyl control the extrapyramidal (parkinsonian) manifestations associated with the neuroleptics and are classified as antiparkinsonian drugs. These drugs do not reduce postural hypotension, nor do they potentiate phenothiazine derivatives or have an effect on depression.

A client admitted to the hospital with a diagnosis of malabsorption syndrome exhibits signs of tetany. The nurse concludes that the tetany was precipitated by the inadequate absorption of which electrolyte?

Calcium The muscle contraction-relaxation cycle requires an adequate serum calcium-phosphorus ratio; the reduction of the ionized serum calcium level associated with malabsorption syndrome causes tetany (spastic muscle spasms). Sodium is the major extracellular cation. Sodium's major route of excretion is the kidneys, under the control of aldosterone. Although it plays a part in neuromuscular transmission, potassium is not related to the development of tetany. Potassium is the major intracellular cation. Potassium is part of the sodium-potassium pump and helps to balance the response of nerves to stimulation. Potassium is not related to the development of tetany. Although phosphorus is closely related to calcium, because they exist in a specific ratio, phosphorus is not related to the development of tetany.

Which drug helps to achieve sufficient maturation of the ovarian follicles?

Choriogonadotropin alfa

Which drug used to promote fertility may cause esophageal burns

Clomiphene is a serum selective receptor modulator that may cause esophageal burns. Estrogen may cause a thromboembolism. Nifedipine may cause maternal fetal problems. Indomethacin may cause birth defects.

best choice of drug for obsessive-compulsive disorder

Clomipramine is a tricyclic antidepressant drug prescribed for treating of obsessive-compulsive disorder. Childhood enuresis necessitates the administration of imipramine. Lithium salt is prescribed to treat bipolar disorders. Dysthymias can be treated by the administration of antidepressant drugs such as amitriptyline.

antipsychotic drugs

Clozapine is a second-generation antipsychotic drug that is more effective than other second-generation antipsychotics. Most (but not all) first- and second-generation antipsychotics are equally effective. Second-generation antipsychotics may cause metabolic side effects such as diabetes and dyslipidemia. First-generation antipsychotics may cause extrapyramidal side effects.

cocaine belongs in what category

Cocaine is classified as a stimulant. It is inhaled in its powdered form or smoked as crack; its use creates experiences similar to but more intense than those experienced with the amphetamines, and its withdrawal results in a deeper crash. Opioids and barbiturates are central nervous system depressants. Hallucinogens produce cerebral excitation that can yield a state similar to psychosis.

Which hormone may cause vaginal carcinoma in a female child after birth?

DES Diethylstilbestrol has a teratogenic effect that may cause vaginal carcinoma in a female child after birth. Progesterone and androgens may cause masculinization of a female fetus. Estrogen may cause congenital defects in the female reproductive system.

what medication may cause masculinization of a female fetus

Danazol is a teratogen that may cause masculinization of a female fetus. Lithium may cause cardiac defects. Nitrofurantoin may cause cleft lips with cleft palates. Carbamazepine may cause neural tube defects.

Which condition is contraindicated for St. John's wort herbal therapy?

Dementia

Which drug may cause gynecologic malignancies in females?

Diethylstilbestrol may cause gynecologic malignancies such as endometrial, ovarian, and cervical cancers. Oxytocin is a hormone and uterotonic agent. It can be used to start or strengthen labor contractions and to control bleeding after childbirth. It is not associated with gynecologic malignancy. Raloxifene is used to prevent postmenopausal osteoporosis. The use of thalidomide during pregnancy may cause birth defects in the newborn.

Which drug is used to manage nonmetastatic gestational trophoblastic disease?

Dinoprostone

What 2-generation antidepressant drug can worsen glaucoma

Duloxetine (Cymbalta) can worsen uncontrolled angle-closure glaucoma. Trazodone is contraindicated in clients with a known drug allergy. Bupropion is contraindicated for clients with seizures. Mirtazapine is contraindicated in cases of known drug allergy and concurrent use of monoamine oxidase inhibitors.

What database should the nurse use to obtain a broad view on biomedical and pharmaceutical studies?

EMBASE The EMBASE database is a good source of biomedical and pharmaceutical studies. PubMed is the health science library at the National Library of Medicine; this database offers free access to many journal articles. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. PsycINFO is a good resource for psychology and psychology-related healthcare disciplines.

high risk for tardive dyskinesia

First-generation antipsychotic drugs such as loxapine and haloperidol may cause tardive dyskinesia, an extrapyramidal reaction. Second-generation antipsychotic drugs such as quetiapine, ziprasidone, and olanzapine have a lower risk of causing extrapyramidal reactions.

drugs for schizophrenia

Fluphenazine is a high-potency medication used for schizophrenia. Loxapine and perphenazine are medium-potency medications used to treat schizophrenia. Thioridazine is a low-potency medication used to treat schizophrenia.

Imipramine, 75 mg three times per day, is prescribed for a client. What nursing action is appropriate when this medication is being administered?

Glaucoma is one of the side effects of imipramine, and the client should be taught about the symptoms. Tolerance is not an issue with tricyclic antidepressants such as imipramine. The other actions are true of monoamine oxidase inhibitors (MAOIs); imipramine is not an MAOI.

Haldol side effects

Haloperidol is an antipsychotic drug used in the long-term treatment of psychosis. Gynecomastia is one of the adverse effects of this drug. Ataxia, asthenia, and insomnia are the adverse effects of clozapine.

A client who has been taking the prescribed dose of zolpidem for 5 days returns to the clinic for a follow-up visit. When interviewing the client, the nurse identifies that the medication has been effective when the client makes which statement?

I have been sleeping better

Which birth control agent requires administration once every three months?

IM progestin

Edema

Interstitial spaces become filled with fluid Symptoms: decreased mobility/elasticity, decreased skin turger(tenting)

Which drug may lead to bruxism?

Levomilnacipran Serotonin reuptake inhibitors and serotonin/epinephrine reuptake inhibitors may lead to bruxism. Levomilnacipran is a serotonin/epinephrine reuptake inhibitor that may cause bruxism. Vilazodone is an atypical antidepressant that does not cause bruxism. Isocarboxazid is a monoamine oxidase inhibitor that does not cause bruxism. Clomipramine is a tricyclic antidepressant that does not cause bruxism.

Which drug may cause Ebstein anomaly as a teratogenic effect and is also contraindicated in breast-feeding clients?

Lithium may cause Ebstein anomaly as a teratogenic effect. This drug is also contraindicated in breast-feeding clients. Ibuprofen is a nonsteroidal antiinflammatory drug that may cause the premature closure of the ductus arteriosus as a teratogenic effect. This drug is safe for breast-feeding clients to use. Vitamin A may cause heart defects as a teratogenic effect. Nitrofurantoin may cause heart defects.

Which drug is administered to women after delivery to prevent postpartum uterine atony and hemorrhage but is not given to augment labor?

Methylergonovine is given to prevent postpartum uterine atony and hemorrhage but should not be used for the augmentation of labor or during a spontaneous abortion. Dinopristone is to terminate a pregnancy. Mifepristone is also used to induce an elective termination of a pregnancy. Indomethacin is used to maintain a pregnancy during preterm labor.

what is modafinil

Modafinil is a unique nonamphetamine stimulant used to treat shift-work sleep disorder (SWSD). This drug promotes wakefulness in clients suffering from excessive sleepiness associated with SWSD. Caffeine is a central nervous stimulant used to promote wakefulness, but this drug is not as effective in the treatment of SWSD. Atomoxetine is a nonstimulant used to treat attention deficit hyperactivity disorder (ADHD). Methylphenidate is considered the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD).

What drug does a nurse anticipate that the primary healthcare provider will prescribe for a client demonstrating clinical manifestations associated with an opioid overdose?

Naloxone is a narcotic antagonist that displaces opioids from receptors in the brain, thereby reversing respiratory depression. Methadone is a synthetic opioid that causes central nervous system depression; it will add to the problem of overdose. Epinephrine and amphetamine will have no effect on respiratory depression related to opioid overdose.

Which drug may cause formation of abnormally small eyes in the newborn if used during pregnancy?

Nitrofurantoin, an antimicrobial drug, causes formation of abnormally small eyes in the newborn. Sex hormone supplements, such as estrogens, may cause congenital defects of female reproductive organs. Methotrexate can cause congenital abnormalities (central nervous system and limbs malformations) and fetal death. Valproic acid is highly teratogenic and causes neural tube defects, atrial septal defect, cleft palate, hypospadias, polydactyly, and craniosynostosis.

Which drug is used to induce spontaneous abortions?

Oxytocin is used for spontaneous or induced abortions. Estradiol may be given to alleviate postmenopausal hot flashes. Progestins are used for birth control. Clomiphene may be used as a fertility drug.

Which hormone can cause ovulation and promote lactation?

Oxytocin stimulates uterine contractions, aids in ovulation, and promotes the movement of milk from the mammary glands to the nipples in lactating mothers. Estrogen and progestin may cause ovulation but do not promote lactation. Vasopressin may help in the retention of water by the kidneys.

When monitoring a client 24 to 48 hours after abdominal surgery, the nurse should assess for which problem associated with anesthetic agents?

Paralytic ileus

A client with an organic mental disorder becomes increasingly agitated and abusive. The primary healthcare provider prescribes haloperidol. For which potential adverse effects will the nurse monitor this client?

Potential adverse effects of the antipsychotic medication haloperidol include pseudoparkinsonism and urinary retention related to extrapyramidal syndrome. Tremors, ataxia (loss of control of body movement), and paresthesias are adverse effects of selective serotonin reuptake inhibitors (SSRIs), but not haloperidol. Likewise, endocrine effects such as a new Type 2 Diabetes mellitus diagnosis and syndrome of inappropriate antidiuretic hormone (SIADH) are not known to occur with haloperidol, but they are adverse effects of SSRIs.

An obese adult develops an abscess after abdominal surgery. The wound is healing by secondary intention and requires repacking and redressing every 4 hours. Which diet should the nurse expect the healthcare provider to prescribe to best meet this client's immediate nutritional needs?

Protein and vitamin C promote wound healing; this is a postoperative priority. Although a low-fat diet is preferred for an obese client, vitamin D, as well as other vitamins, should not be limited. A high-calorie diet can increase obesity, and there is no indication that this client is at risk for constipation requiring a high-fiber diet. A low-residue bland diet can cause constipation; the priority is for nutrients to promote healing.

how to administer rho(d)

Rho(D) immune globulin is given to Rh-negative mothers not previously sensitized who have Rh-positive neonates; it prevents Rh incompatibility in the next pregnancy. Rho(D) immune globulin is administered intramuscularly, not intravenously or subcutaneously. There is no need for the client to fast; the client may eat and drink before receiving this medication.

A client at 30 weeks' gestation is admitted in preterm labor. An intravenous solution of the tocolytic agent ritodrine is started. The client asks why the drug is being administered. How will the nurse respond?

Ritodrine is given to promote uterine relaxation. Although ritodrine may cause fetal hyperglycemia and neonatal hypoglycemia, it is not given for this purpose. Glucocorticoids such as betamethasone are given to stimulate fetal lung maturity. Ritodrine does not have a role in counteracting adverse reactions.

Which antidepressant drug is a selective monoamine oxidase-B inhibitor

Selegiline

Which monoamine oxidase inhibitor is used to treat Parkinson disease

Selegiline is a monoamine oxidase-B inhibitor used to treat Parkinson disease. Phenelzine, isocarboxazid, and tranylcypromine are nonselective inhibitors of both type A and B used in the treatment of depression.

When assessing a client's fluid and electrolyte status, the nurse recalls that the regulator of extracellular osmolarity is what

Sodium is the most abundant extracellular fluid cation and regulates serum (extracellular) osmolarity, as well as nerve impulse transmission and acid-base balance. Potassium is the major intracellular osmolarity regulator, and it also regulates metabolic activities, transmission and conduction of nerve impulses, cardiac conduction, and smooth and skeletal muscle contraction. Chloride is a major extracellular fluid anion and follows sodium. Calcium is an extracellular cation necessary for bone and teeth formation, blood clotting, hormone secretion, cardiac conduction, transmission of nerve impulses, and muscle contraction.

A client with schizophrenia is given an antipsychotic drug. The nurse recalls all the extrapyramidal effects associated with this type of medication and anticipates that the drug will be discontinued if which occurs?

Tardive dyskinesia is characterized by protrusion and vermicular movements of the tongue, chewing and puckering movements of the mouth, and a puffing of the cheeks. These adverse effects may or may not be reversible when the antipsychotic medication is withdrawn. Motor restlessness (akathisia), parkinsonian symptoms, or an acute dystonic reaction can be treated with an antiparkinsonian or anticholinergic drug while the antipsychotic medication is continued.

A client making her first visit to the prenatal clinic asks which immunization can be administered safely to a pregnant woman. What should the nurse tell her?

The inactive influenza and diphtheria, tetanus, pertussis (dTAP) immunizations can be safely administered during the first trimester of pregnancy, although dTAP is recommended at 27 to 36 weeks' gestation to provide immunity to the mother and infant. The inactivated influenza vaccine may be given because it is a killed virus vaccine and will not have a teratogenic effect. Rubella (measles) and rubeola (German measles) vaccines are both live viruses that should never be administered during pregnancy because they can have teratogenic effects. Varicella (chicken pox) immunization is not given because it may cause birth defects in the fetus.

the clinic nurse is planning care for a client found to have chlamydia. Which treatment should the nurse plan to implement?

The treatment of choice for chlamydial infection is 1 g of azithromycin orally in a single dose. The one-dose course is preferred because of its ease of completion. Acyclovir may be prescribed in a 7-day course for a genital herpes outbreak. Administering 250 mg of ceftriaxone intramuscularly in a single dose is the drug therapy recommended for gonorrhea. Benzathine penicillin G given intramuscularly as a single 2.4 million unit dose is the treatment for primary, secondary, and early latent syphilis.

How should the nurse prevent footdrop in a client with a leg cast

To prevent footdrop (plantar flexion of the foot due to weakness or paralysis of the anterior muscles of the lower leg) in a client with a cast, the foot should be supported with 90 degrees of flexion

A client is started on chlorpromazine. To prevent life-threatening complications from the administration of this medication to an anxious, restless client, it is important that the nurse take which action?

Vital signs Tachycardia, hyperpyrexia, and tachypnea are indications of neuroleptic malignant syndrome, which is a life-threatening complication. Restraint of any type may worsen the client's anxiety and result in struggling and increased agitation. Photosensitivity occurs most commonly when clients are taking large doses and are spending time outdoors in the sun, but it is not life threatening. Tardive dyskinesia results from prolonged large doses of phenothiazines in susceptible clients, but it is not life threatening.

Which client condition is contraindicated for prescribing clozapine?

bone marrow depression

Which pregnancy safety category shows a proven risk of fetal harm, but potential benefits of use during pregnancy may be acceptable despite its risks?

category d Category D drugs show a proven risk of fetal harm; however, potential benefits of its use during pregnancy are acceptable in case there is a life-threatening disease. Category A drugs pose little to no risk of fetal harm. Category X drugs have been proven to harm the fetus; the risks outweigh the possible benefits of using this drug. Category C drugs have harmed animal fetuses, but there is no conclusive evidence that the drug may harm human fetuses.

Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid?

circulatory collapse The clinical symptoms of monoamine oxidase inhibitors (MAOIs) generally appears after 12 hours of ingestion. Circulatory collapse is associated with MAOI toxicity. Mydriasis, bradycardia, and hyperthermia are not associated with an isocarboxazid overdose.

Which drug may cause photophobia as an adverse effect?

clomiphene is a fertility drug that may cause photophobia. Nifedipine may cause maternal fetal problems. Aldenorate may cause dysphagia. Indomethacin may cause birth defects.

A client with schizophrenia who is receiving an antipsychotic medication begins to exhibit a shuffling gait and tremors. The primary healthcare provider prescribes the anticholinergic medication benztropine, 2 mg daily. What will the nurse assess the client for daily when administering these medications together?

constipation The anticholinergic activity of each drug is magnified, and adverse effects such as paralytic ileus may occur. Hypotension, not hypertension, occurs with anticholinergic medications. Dryness of the mouth, not increased salivation, occurs with anticholinergic medications. Decreased, not increased, perspiration occurs with anticholinergic medications.

Which intrinsic factor is associated with the fall of an older adults

deconditioning

Which type of breathing pattern alteration is manifested with hypercarbia

hypercarbia may occur during hypoventilation. The respiratory rate is abnormally low and the depth of ventilation is depressed in hypoventilation. In eupnea, the normal rate and depth of respiration is interrupted while singing. The rate of breathing is regular, but abnormally rapid in tachypnea. Respirations are abnormally deep, regular, and the rate is increased in Kussmaul's respirations.

A client is receiving haloperidol for agitation, and the nurse is monitoring the client for side effects. Which response identified by the nurse is unrelated to an extrapyramidal tract effect?

hypertensive crisis

A client with depression is to be given fluoxetine (Prozac). What precaution will the nurse consider when initiating treatment with this drug?

improvement in 2-4 weeks. does not produce an immediate effect; nursing measures must be continued to reduce the risk for suicide. Consuming milk and crackers to help prevent hyperacidity and discomfort is not necessary. Avoiding cheese, pickled herring, and wine is a precaution taken with the monoamine oxidase inhibitors. Weekly blood level checks are not necessary with fluoxetine.

A client with a history of methamphetamine use is admitted to the medical unit. What clinical manifestation does the nurse expect when assessing the client?

increased heart rate (stimulant)

A pregnant woman with cervical stenosis has been admitted to the hospital for a labor induction. Which drug should be administered?

oxytocin

Which hypothalamic hormone helps to treat postpartum uterine atony and hemorrhage?

oxytocin

An older adult in an acute care setting is experiencing emotional stress because of a recent surgery. Which intervention would be most appropriate for the client?

reality orientation A client who has undergone surgery may experience emotional stress leading to disorientation. Reality orientation is an appropriate intervention to minimize the client's disorientation. Touch is a therapeutic tool that helps to induce relaxation, provide physical and emotional comfort, and communicate interest. Reminiscence helps to bring meaning and understanding to the present and resolve current conflicts by recollecting the past. Validation therapy is a communication technique that can help a client in a confused state.

Which developmental changes should be evaluated in girls around 12 years of age?

skeletal growth Girls around the age of 12 years of age may develop scoliosis (a lateral curvature of the spine); therefore, skeletal growth should be evaluated. Motor skills should be evaluated in preschool children. Visual acuity should be evaluated in school-age children. Hormonal changes should be evaluated in adolescents.

A nurse is reviewing how a hyperglycemic client's blood glucose can be lowered. The nurse recalls that the chemical that buffers the client's excessive acetoacetic acid is what

sodium bicarbonate

enteral feedings

To prevent aspiration, the nurse should keep the head of the bed elevated between 30 and 45 degrees. Elevating the head any higher causes increased sacral pressure and increases the risk of skin breakdown. Decreasing flow rate, checking residual, and irrigating regularly will not prevent aspiration.

A client who has been taking a conventional antipsychotic for several days comes to the clinic complaining of neck spasms. The figure illustrates the client's physical status observed by the nurse. What extrapyramidal side effect has the client developed?

Torticollis is an acute dystonia that involves muscle spasms of the head and neck. Torticollis develops within 1 to 5 days after beginning therapy with a conventional antipsychotic. Tardive dyskinesia is involuntary repetitious tonic muscular spasms that involve the face, tongue, lips, limbs, and trunk. Tardive dyskinesia takes several months to years to develop after the start of therapy with a conventional antipsychotic. Pseudoparkinsonism is an extrapyramidal tract response that includes masklike facies, shuffling gait, pill-rolling tremors, stooped posture, and drooling. Pseudoparkinsonism develops within several days to 1 month after the start of therapy with a conventional antipsychotic. Neuroleptic malignant syndrome is a severe, potentially fatal (10%) response to conventional antipsychotics. It is believed to be caused by an acute reduction in brain dopamine activity, precipitating hyperthermia, tachycardia, tachypnea, unstable blood pressure, hypertonicity, dyskinesia, incontinence, decreased level of consciousness, and pulmonary congestion. Neuroleptic malignant syndrome can occur during the first week of therapy but often occurs later during therapy.

drugs for GAD

-Buspirone (nonaddictive) -benzos (enhance GABA, tolerance, short term) -antiadrenergics ( tx physical symptoms, speakers use it, inderal, propranolol, clonidine, catapres - antidepressnats (non addictive) -antihistamines (ptsd mostly, vistaril, atarax) Duloxetine, venlafaxine, and escitalopram are antidepressants approved for the treatment of generalized anxiety disorder (GAD). Clonazepam and clomipramine are used to treat panic disorders.

Bupropion (Wellbutrin)

Bupropion is contraindicated in clients with eating and seizure disorders. Trazodone is contraindicated in clients with a known allergic reaction to this drug. Amitriptyline is contraindicated in clients who are pregnant and have known allergic reactions to this drug. Lithium citrate is contraindicated in clients with renal or cardiovascular disease.

Which medication is indicated for evacuation in case of a miscarriage?

Dinoprostone is a prostaglandin E 2 abortifacient and cervical ripening drug, which is indicated for uterine evacuation in cases of miscarriage. Clomiphene is indicated for female infertility in some clients. Magnesium sulfate is used to treat pregnancy-induced hypertension. Methylergonovine is used to treat postpartum uterine atony and hemorrhage.

domains of nursing intervention phase

Domain 2 of the nursing intervention phase includes electrolyte and acid-base management. Domain 2, or the physiologic complex, includes care that supports homeostatic regulation. Domain 1 includes care that supports physical functioning. Domain 3 incorporates care that supports psychosocial functioning and facilitates lifestyle changes. Domain 4 involves care that supports protection against harm.

Which critical thinking skill refers to the use of knowledge and experience to choose effective client care strategies

Explanation ... involves using knowledge and experience to choose strategies to use to care for clients. Evaluation is applicable when using criteria to determine the results of nursing actions. Interpretation is involved in the orderly collection of data. Self-regulation is applicable when the nurse identifies ways to improve his or her own performance.

Which statement defines the term family resiliency?

Family resiliency is the ability of the family to cope with expected and unexpected stressors. Family diversity is the uniqueness of each family. Family durability is the interfamilial support system that extends beyond the walls of the household. The parents of this family may remarry or children may leave the home as adults, however, the family is capable of transcending inevitable lifestyle changes.

ADHD drug of choice

Methylphenidate is the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD). Clonidine, guanfacine, and atomoxetine are nonstimulants used to treat ADHD; these medications are less effective than methylphenidate.

Which drug is known as an abortion pill?

Mifepristone activates uterine contractions and causes abortion. This drug is used in the voluntary termination of pregnancy and is known as the abortion pill. Pregnant women are sensitive to oxytocin, which causes uterine concentrations and may lead to abortion. Misoprostol is a synthetic prostaglandin usually given with mifepristone. Methylergonovine is an ergot alkaloid used to treat postpartum hemorrhage.

A client is being admitted to a medical unit with a diagnosis of pulmonary tuberculosis. The nurse should assign the client to which type of room?

Negative-airflow room Tuberculosis is an airborne contagious disease that is best contained in a negative-airflow room. Negative-airflow rooms are always private. A private room, semiprivate room, and a room with windows that can be opened are not appropriate for the standard of care for a client diagnosed with tuberculosis. Additionally, opening windows would present a possible safety hazard in a client's room.

Which atypical antipsychotics are approved for long-term use to prevent the recurrence of mood episodes in clients with bipolar disease? Select all that apply.

Olanzapine Ziprasidone Aripiprazole

what disease is at risk for hyperkalemia

One of the kidneys' functions is to eliminate potassium from the body; diseases of the kidneys often interfere with this function, and hyperkalemia may develop, necessitating dialysis. Clients with Crohn disease have diarrhea, resulting in potassium loss. Clients with Cushing disease will retain sodium and excrete potassium. Clients with gastroesophageal reflux disease are prone to vomiting that may lead to sodium and chloride loss with minimal loss of potassium

A nurse assesses for hypocalcemia in a postoperative client. What is one of the initial signs that might be present?

Paresthesias Normally, calcium ions block the movement of sodium into cells. When calcium is low, this allows sodium to move freely into cells, creating increased excitability of the nervous system. Initial symptoms are paresthesias. This can lead to tetany if untreated. Headache, pallor, and blurred vision are not signs of hypocalcemia.

A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the follow-up appointment, the client reports tremors, shortness of breath, a fever, and sweating. What will the nurse do?

take vital signs and take him to hospital These clinical manifestations signal the presence of neuroleptic malignant syndrome; the cardinal sign of this condition is a high body temperature. Therefore the nurse first should document the hyperthermia and then arrange for immediate hospitalization. Unless the client is experiencing impaired ventilation, it is important to complete a focused assessment before transfer. The care needed can be provided in an emergency department or medical unit, not a psychiatric unit. Neuroleptic malignant syndrome may occur without an overdose; this syndrome can occur when a high-potency antipsychotic drug is prescribed, with typical onset within 3 to 9 days after initiation of the medication. Benztropine will have little or no effect on neuroleptic malignant syndrome.

Which approach is a comforting approach that communicates concern and support?

touch Rationale Touch is a comforting approach that involves reaching out to clients to communicate concern and support. Listening is a critical component of nursing care and is necessary for meaningful interactions with clients. Knowing the client comprises both the nurse's understanding of a specific client and his or her subsequent selection of interventions. Providing presence is a person-to-person encounter that conveys a closeness and sense of caring.

Stages of Erikson's Theory

trust vs mistrust (birth-1) autonomy vs shame and doubt (1-3) initiative vs guilt (3-6) industry vs inferiority (6-11) identity vs role confusion (11-18) intimacy vs isolation (18-40) generativity vs stagnation (40-65) integrity vs despair (over 65)

A client is receiving antibiotics and antifungal medications for the treatment of a recurring vaginal infection. What should the nurse encourage the client to do to compensate for the effect of these medications?

yogurt contains Lactobacillus acidophilus, which replaces the intestinal flora destroyed by antibiotics. Spicy foods, fruit juices, and multivitamins are not relevant to antibiotics or intestinal flora.