Week 6 assignment 2 - good PDF

Preview

Summary

good ...

Description

Fundamentals of Nursing Practice- Medication administration Please answer all questions and hand in class. 1. Explain peak and trough? You are to administer carbamazepine to your client at 8am. What time would you draw a peak level for this client? Peak is the highest point of therapeutic effect of a medication in the blood, the trough is the lowest therapeutic effect in the blood. When administering carbamazepine the peak level would be drawn right before the next dose. 2. Mr. Smith is admitted with Signs and symptoms of a CVA (stroke). Treatment for CVAs include the use of a thrombolytic (clot busters) like TPA. When would the physician not give a Thrombolytic? What imaging test do you foresee will R/O (rule out) that contraindication? A physician would not want to give a patient TPA if their signs or symptoms indicated a brain bleed of some sort, a CT scan could rule that out. 3. Your client had a gastrostomy tube insertion. What is the most certain way to insure proper placement? The most certain way to check placement is with a chest x-ray. Another way could be to pull gastric juice and test the pH, lastly you can take an empty syringe and auscultate the area of the stomach to hear the puff of air the nurse pushes into the tube. 4. You have just begun your shift at 7am and Mr. Fitbit has a NTP (Nitropaste) patch applied to his chest at 5am. You are taking his vital signs, and you notice that the BP is 80/ 50. What is your first action? What is your next action? Since I know that NTP can lower the clients blood pressure I would notify the provider of the low blood pressure and see if removing the NTP patch is a good next step.

5. Mr. Vincent receives eye drops to both eyes at bedtime (HS). What is the correct method of applying eye drops? What is the correct term for “drops”? Taking the drops in your dominance hand you ask the patient to tilt their head back and lookup, the nurse pulls down on the eye lid and you insert the drop into the inner eye lip and tell them to hold it there and not blink too hard.

6. You are to administer the morning dose of Regular Insulin to your diabetic patient. The glucometer reads a blood sugar of 50. What is your first action? Which of the following would you do? Select all that apply

a. Call MD b. Hold insulin c. Give insulin d. Give patient a snack e. Notify MD

7. You are doing your first morning rounds and assessing the patients under your care. One of your patients IV site (saline lock) is red, warm and tender to touch. You assess this as signs and symptoms of -------------------. What is your first action? What nursing independent action can you provide this patient to improve his symptoms? My first action would be to stop the drip going into that Iv, as a nurse I could change the placement of the iv and start a new line so that they receive their medication. I would notify the MD of their reaction and let them know what I did to remedy it.

8. The patient is on Coumadin daily for his atrial fibrillation. What lab test is necessary to obtain and maintain a therapeutic level? Please be specific Lab values for Coumadin are PTT and INR

9. A patient admitted with chest pain is to be initiated to a continuous drip of Heparin. This blood thinner requires a daily blood test to titrate dosage. What lab test is required to maintain a therapeutic level of heparin in this patient? APTT is a therapeutic level test for heparin]

10. DVT(Deep Vein Thrombosis) prophylaxis is often initiated for immobilized patients to prevent clot formation. What medication is most commonly used? Where is the recommended type of injection required for this medication? Where can you administer this medication? What would you watch for in patients who are treated with Thrombus prophylaxis? Lovanox a low molecular weight heparin is mostly used for prophylaxis, this type of injection is recommended to be put into the abdomen. Bleeding is always a risk whenever taking any blood thinner....