Showing posts with label Psychosocial Integrity. Show all posts

After total hip replacement, a client is receiving epidural analgesia to relieve pain.. Assessing for sensation in the legs

After total hip replacement, a client is receiving epidural analgesia to relieve pain.

Which of the following is a nursing priority for this client?

A. Changing the catheter site dressing every shift
B. Assessing capillary refill time
C. Assessing for sensation in the legs
D. Keeping the client flat in bed

Answer C.

For epidural analgesia, a catheter is placed outside the dura mater in the epidural space. Catheter displacement, which may cause spinal injury, is signaled by loss of motion and sensation in the legs. Therefore, the nurse should assess closely for sensation and ask about numbness of the legs. The nurse should change the catheter site dressing every day or every other day. Capillary refill time has no bearing on epidural analgesia. A client with an epidural catheter may ambulate and need not be confined to bed.

The correct answer is: C. Assessing for sensation in the legs

After total hip replacement, a client receiving epidural analgesia is at risk of developing a spinal hematoma, which can cause neurological damage. Assessing for sensation in the legs is a priority to detect any signs of spinal cord compression, such as numbness or weakness.

Here's why the other options are incorrect:

A. Changing the catheter site dressing every shift: While it's important to monitor the catheter site for signs of infection or leakage, changing the dressing every shift is not a priority compared to assessing for neurological complications.
B. Assessing capillary refill time: Capillary refill time is a general assessment of circulation, but it's not specifically related to the risk of spinal hematoma after epidural analgesia.
D. Keeping the client flat in bed: Maintaining the client in a flat position is not a priority in this situation. In fact, it can increase the risk of blood clots. The client should be encouraged to move around as tolerated to prevent complications.

Therefore, assessing for sensation in the legs is the most important nursing priority for a client receiving epidural analgesia after total hip replacement.

Assessing for Sensation in the Legs: A Priority for Clients Receiving Epidural Analgesia After Total Hip Replacement

Epidural analgesia is a common pain management technique used after total hip replacement surgery. It involves injecting a pain medication into the epidural space, which is the space between the spinal cord and the vertebrae. While epidural analgesia can effectively relieve pain, it also carries the risk of complications, including spinal hematoma.

Spinal hematoma is a serious condition that occurs when blood collects in the epidural space, compressing the spinal cord. This can lead to neurological symptoms, such as numbness, weakness, or loss of sensation in the legs.

Assessing for sensation in the legs is a crucial nursing intervention to detect early signs of spinal hematoma. This can help prevent further neurological damage and allow for prompt treatment.

Here's a more detailed explanation of why assessing for sensation in the legs is a priority:

Early Detection: By regularly assessing for changes in sensation, nurses can identify early signs of spinal hematoma, even before more severe symptoms develop.
Prevention of Further Damage: Early detection and intervention can help prevent further neurological damage, which can be irreversible if not treated promptly.
Prompt Treatment: If a spinal hematoma is suspected, immediate medical attention is necessary to relieve pressure on the spinal cord and prevent permanent damage.

How to Assess for Sensation in the Legs:

Ask the client: Inquire about any numbness, tingling, or weakness in the legs.
Perform a physical examination: Assess the client's leg strength, reflexes, and sensation using appropriate techniques.
Document findings: Record the results of your assessment in the client's medical record.

Other Nursing Priorities:

While assessing for sensation in the legs is a critical priority, there are other important nursing interventions to consider for clients receiving epidural analgesia after total hip replacement:

Monitor vital signs: Regularly monitor the client's blood pressure, heart rate, respiratory rate, and oxygen saturation.
Assess pain levels: Use a pain assessment tool to evaluate the client's pain and adjust the epidural medication as needed.
Monitor for signs of infection: Inspect the epidural catheter site for redness, swelling, or drainage.
Prevent blood clots: Encourage the client to move around as tolerated to prevent deep vein thrombosis.
Provide emotional support: Offer emotional support and reassurance to the client and their family.

By prioritizing these nursing interventions, healthcare professionals can help ensure the safety and well-being of clients receiving epidural analgesia after total hip replacement.

Nurse Tony is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in the plan?

A. Restrict visits with the family until the client begins to eat
B. Provide privacy during meals
C. Set up a strict eating plan for the client
D. Encourage the client to exercise, which will reduce her anxiety

Answer C.

Establishing a consistent eating plan and monitoring the client’s weight are important for this disorder. The family should be included in the client’s care. The client should be monitored during meals — not given privacy. Exercise must be limited and supervised.

The correct answer is B. Provide privacy during meals.

Here's a breakdown of why this is the most appropriate action:

Privacy: People with anorexia often feel self-conscious about their eating habits and may be more likely to eat if they feel they have privacy.
Restricting visits: This can be harmful as it can isolate the client and worsen their mental state. Family support is often crucial in recovery.
Strict eating plan: While a structured meal plan can be helpful, it's important to approach it collaboratively with the client to avoid triggering negative emotions or behaviors.
Exercise: While exercise can be beneficial for overall health, it's important to avoid excessive exercise, as it can contribute to the disordered eating patterns in anorexia.

Providing privacy during meals is a compassionate and effective strategy that can encourage the client to eat and make progress in their recovery.

Nursing Care for Anorexia Nervosa:

Understanding Anorexia Nervosa:

A Complex Disorder: Anorexia nervosa is a complex eating disorder characterized by an intense fear of gaining weight, leading to restricted eating and unhealthy weight loss.
Psychological Factors: The disorder often involves distorted body image, low self-esteem, and perfectionism.
Physical Consequences: Anorexia can have severe physical consequences, including malnutrition, organ damage, and even death.

Developing a Comprehensive Care Plan:

Collaborative Approach: A comprehensive care plan for anorexia nervosa should involve a multidisciplinary team, including a psychiatrist, psychologist, dietitian, and nurse.
Individualized Goals: The plan should be tailored to the client's specific needs and goals, taking into account their physical and psychological state.
Gradual Weight Gain: A gradual approach to weight gain is often recommended to avoid refeeding syndrome, a potentially life-threatening condition.

Key Nursing Interventions:

Therapeutic Relationship: Building a trusting and supportive relationship with the client is essential for effective care.
Monitoring Vital Signs: Close monitoring of vital signs, including heart rate, blood pressure, and weight, is crucial to detect any complications.
Nutritional Support: A dietitian can help develop a balanced and nutritious meal plan that meets the client's caloric needs.
Cognitive-Behavioral Therapy: CBT can help clients identify and challenge negative thoughts and behaviors related to their eating disorder.
Family Therapy: Involving the family in the treatment process can be beneficial, as they can provide support and encouragement.
Medication Management: In some cases, medication may be prescribed to address underlying psychiatric conditions, such as depression or anxiety.

Overcoming Challenges:

Resistance to Treatment: Clients with anorexia may resist treatment or engage in behaviors to sabotage their recovery.
Body Image Issues: Addressing distorted body image and improving self-esteem is a key component of treatment.
Relapse Prevention: Developing relapse prevention strategies is important to help clients maintain progress and avoid returning to unhealthy eating patterns.

By providing a comprehensive and supportive care plan, nurses can play a vital role in helping clients with anorexia nervosa overcome their disorder and achieve a healthy recovery.

An attorney who throws books and furniture around the office after losing a case is referred to the psychiatric nurse in the law firm’s employee assistance program.

Nurse Lyn knows that the client’s behavior most likely represents the use of which defense mechanism?

A. Regression.
B. Projection.
C. Reaction-formation.
D. Intellectualization.

Out of the options provided, the attorney's behavior most likely represents the use of A. Regression.

Here's why:

- Regression:

This defense mechanism involves reverting to earlier, less mature behaviors in response to stress or anxiety. Throwing books and furniture is a childish and impulsive way of expressing anger and frustration, which aligns with the characteristics of regression.

- Projection:

This defense mechanism involves attributing one's own negative thoughts or feelings to others. While the attorney might blame others for the lost case, throwing things is not a typical way to project blame.

- Reaction-formation:

This defense mechanism involves developing strong positive behaviors or attitudes to compensate for unconscious negative thoughts or feelings. Throwing things is not a positive behavior and doesn't seem to compensate for any underlying feelings.

- Intellectualization:

This defense mechanism involves detaching oneself emotionally from a situation by focusing on the intellectual aspects. Throwing things is a highly emotional response and doesn't involve intellectualization.

Therefore, regression is the most fitting explanation for the attorney's behavior in this scenario. It's important to note that this is not a definitive diagnosis and a qualified mental health professional would be needed to make a proper assessment.

It's crucial to remember that seeking help for mental health concerns is crucial, and employee assistance programs can be a valuable resource for individuals struggling with emotional difficulties.

A child is admitted to the pediatric unit with a serum sodium level of 118 mEq/L. Which nursing action takes highest priority at this time?

a. Replacing fluids slowly as ordered.
b. Instituting seizure precautions.
c. Administering diuretic therapy as prescribed.
d. Administering sodium bicarbonate as prescribed.

Answer B.

A serum sodium level of 118 mEq/L indicates severe hyponatremia, which places the client at risk for seizures. Therefore, instituting seizure precautions takes highest priority. Fluid and sodium replacement should be done rapidly. Diuretic therapy isn’t indicated because it may cause additional sodium loss. In a child with hyperkalemia, administering sodium bicarbonate would be appropriate because it promotes movement of potassium into the intracellular spaces.

Out of the listed options, the nursing action that takes the highest priority for a child with a serum sodium level of 118 mEq/L is: a. Replacing fluids slowly as ordered.

Here's why:

Hyponatremia, defined as a serum sodium level below 135 mEq/L, can be a life-threatening condition in children, especially when severe (less than 125 mEq/L). It can lead to seizures, coma, and even death.

Rapid correction of hyponatremia can be dangerous and lead to potentially fatal complications like cerebral edema. Therefore, slow and controlled fluid replacement is crucial.

The specific rate of fluid replacement will depend on the severity of hyponatremia, the underlying cause, and the child's individual circumstances. It's important to follow the doctor's orders and closely monitor the child's response to treatment.

Other Options:

While the other options might be part of the overall treatment plan, they are not as urgent as immediate fluid replacement in this critical situation:

- Instituting seizure precautions:

While seizures are a potential risk in severe hyponatremia, the immediate priority is to prevent further deterioration by correcting the electrolyte imbalance. Once the sodium level starts rising, the risk of seizures will decrease.

- Administering diuretic therapy:

Diuretics are typically used to remove excess fluid from the body, which can worsen hyponatremia. They are not indicated in this case as the child needs fluid replacement, not removal.

- Administering sodium bicarbonate:

While sodium bicarbonate can be used in some cases of hyponatremia associated with metabolic acidosis, it's not the first-line treatment and should only be administered under the doctor's supervision.

Remember, hyponatremia is a serious medical condition requiring prompt and careful management. If you encounter a child with hyponatremia, prioritize slow and controlled fluid replacement as per the doctor's orders and monitor the child closely for any signs of worsening.

A child, age 4, is admitted with a tentative diagnosis of congenital heart disease.

When assessment reveals a bounding radial pulse coupled with a weak femoral pulse, nurse Ellen suspects that the child has:

a. patent ductus arteriosus.
b. coarctation of the aorta.
c. a ventricular septal defect.
d. truncus arteriosus.

Answer B.

Coarctation of the aorta causes signs of peripheral hypoperfusion, such as a weak femoral pulse and a bounding radial pulse. These signs are rare in patent ductus arteriosus, ventricular septal defect (VSD), and truncus arteriosus.

Based on the presented information, the most likely diagnosis for the child with a bounding radial pulse and weak femoral pulse is: b. coarctation of the aorta (CoA)

Here's why:

- Patent ductus arteriosus (PDA):

This congenital heart defect involves a persistent opening between the aorta and pulmonary artery. While it can cause bounding pulses, it typically wouldn't lead to a significant difference in strength between the radial and femoral pulses.

- Ventricular septal defect (VSD):

This defect involves a hole in the wall between the heart's ventricles. While VSDs can cause various symptoms, a significant difference in pulse strength between the upper and lower extremities is not a typical presentation.

- Truncus arteriosus:

This rare defect involves a single large artery arising from the heart instead of the separate aorta and pulmonary artery. While it can cause various symptoms, the specific pulse findings described are more consistent with coarctation of the aorta.

Coarctation of the aorta (CoA):

is a congenital malformation where the aorta is narrowed in a specific location, typically just beyond the left subclavian artery. This narrowing restricts blood flow to the lower body, leading to:

- Bounding radial pulses:

Due to the increased pressure in the upper body arteries caused by the narrowing.

- Weak femoral pulses:

Due to the decreased blood flow reaching the lower body.

Therefore, considering the child's symptoms and the typical presentation of CoA, nurse Ellen's suspicion of this diagnosis is most likely accurate.

It's important to remember that this is only a preliminary assessment based on limited information. A thorough medical evaluation and additional tests are crucial for confirming the diagnosis and determining the best course of treatment.

A client with heart failure has been receiving an I.V. infusion at 125 ml/hour. Now the client is short of breath and the nurse notes bilateral crackles, neck vein distention, and tachycardia.

What should nurse Sharon do first?

a. Notify the physician
b. Discontinue the infusion
c. Administer a prescribed diuretic
d. Slow the infusion and notify the physician

Answer D.

Because this client has fluid overload, the nurse first should slow the infusion to prevent additional fluid overload, and then notify the physician and obtain further orders.

Notifying the physician without slowing the infusion would put the client at risk for pulmonary complications or respiratory failure. Discontinuing the infusion is inappropriate because vascular access still may be needed to administer I.V. fluids (at a decreased rate) or additional I.V. medications. Administering a diuretic without changing the I.V. infusion rate wouldn’t prevent fluid overload from recurring.

slow the infusio:

Yes, the nurse should slow the infusion and notify the physician if a client with heart failure who has been receiving an IV infusion at 125 ml/hour is now short of breath and the nurse notes bilateral crackles, neck vein distention, and tachycardia. These are all signs and symptoms of fluid overload, which is a serious complication of heart failure.

reduce the amount of fluid:

Fluid overload occurs when the body is unable to keep up with the demand to excrete fluids. This can lead to a buildup of fluid in the lungs, which can make it difficult to breathe. Fluid overload can also cause swelling in the feet, ankles, and abdomen.

The nurse should slow the infusion immediately to reduce the amount of fluid entering the client's body. The nurse should also notify the physician so that they can assess the client's condition and determine the best course of treatment.

excrete fluids:

In addition to slowing the infusion, the physician may also order medications to help the client excrete fluids, such as diuretics. The physician may also need to restrict the client's fluid intake.

If the client's fluid overload is severe, the physician may need to admit the client to the hospital for further treatment.

Steps to be taken:

Here is a summary of the steps the nurse should take:

Slow the infusion immediately.
Notify the physician.
Monitor the client's vital signs and breathing closely.
Position the client in a comfortable position, such as sitting upright.
Provide the client with supplemental oxygen as needed.
Encourage the client to cough up any secretions.
Administer medications as prescribed by the physician.

By taking these steps, the nurse can help to manage the client's fluid overload and prevent serious complications.

A client with a history of substance abuse has been attending Alcoholics Anonymous meetings regularly in the psychiatric unit.. You seem upset about the meetings

A client with a history of substance abuse has been attending Alcoholics Anonymous meetings regularly in the psychiatric unit.

One afternoon, the client tells the nurse, “I’m not going to those meetings anymore.

I’m not like the rest of those people.

I’m not a drunk. “What is the most appropriate response?

a- If you aren’t an alcoholic, why do you keep drinking and ending up in the hospital?
b- It’s your decision. If you don’t want to go, you don’t have to
c- You seem upset about the meetings
d- You have to go to the meetings. It’s part of your treatment plan

Answer C.
The substance abuser uses the substance to cope with feelings and may deny the abuse.

Asking if the client is upset about the meetings encourages the client to identify and deal with feelings instead of covering them up.

A client is admitted for an overdose of amphetamines. When assessing this client, nurse Pauleen should expect to see.. Tension and irritability

A client is admitted for an overdose of amphetamines.

When assessing this client, nurse Pauleen should expect to see:

a- Tension and irritability

b- Slow pulse

c- Hypotension

d- Constipation

Answer A.
An amphetamine is a nervous system stimulant that is subject to abuse because of its ability to produce wakefulness and euphoria.
An overdose increases tension and irritability.

A client begins to experience alcoholic hallucinosis. What is the best nursing intervention at this time.. Providing a quiet environment and administering medication as needed and prescribed

A client begins to experience alcoholic hallucinosis. What is the best nursing intervention at this time?

a- Keeping the client restrained in bed

b- Checking the client’s blood pressure every 15 minutes and offering juices

c- Providing a quiet environment and administering medication as needed and prescribed

d- Restraining the client and measuring blood pressure every 30 minutes

Answer C.
Manifestations of alcoholic hallucinosis are best treated by providing a quiet environment to reduce stimulation and administering prescribed central nervous system depressants in dosages that control symptoms without causing oversedation.
Although bed rest is indicated, restraints are unnecessary unless the client poses a danger to himself or others.
Also, restraints may increase agitation and make the client feel trapped and helpless when hallucinating.
Offering juice is appropriate, but measuring blood pressure every 15 minutes would interrupt the client’s rest.
To avoid overstimulating the client, the nurse should check blood pressure every 2 hours.

A client has a nursing diagnosis of Ineffective airway clearance related to poor coughing. When planning this client’s care.. Teaching the client how to deep-breathe and cough

A client has a nursing diagnosis of Ineffective airway clearance related to poor coughing. When planning this client’s care, nurse Melvin should include which intervention?

a- Increasing fluids to 2,500 ml/day
b- Teaching the client how to deep-breathe and cough
c- Improving airway clearance
d- Suctioning the client every 2 hours

Answer B.
Interventions should address the etiology of the client’s problem — poor coughing. Teaching deep breathing and coughing addresses this etiology. Increasing fluids may improve the client’s condition but doesn’t address poor coughing. Improving airway clearance is too vague. Suctioning isn’t indicated unless other measures fail to clear the airway.

An adolescent with well-controlled insulin-dependent diabetes mellitus has assumed complete management of the disease and wants to participate in gymnastics after school

An adolescent with well-controlled insulin-dependent diabetes mellitus has assumed complete management of the disease and wants to participate in gymnastics after school.

To ensure safe participation, nurse Eve should instruct the child to adjust the therapeutic regimen by:
a- eating a snack before each gymnastics practice
b- measuring the urine glucose level before each gymnastics practice
c- measuring the blood glucose level after each gymnastics practice
d- increasing the morning dosage of intermediate-acting insulin

Answer A.
Because exercise decreases the blood glucose level, the nurse should instruct the child to eat a snack before engaging in physical activity to prevent a hypoglycemic episode.

Nurse Cecile is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome.. drink liquids only between meals

Nurse Cecile is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:
a- restrict fluid intake to 1 qt (1,000 ml)/day
b- drink liquids only with meals
c- don’t drink liquids 2 hours before meals
d- drink liquids only between meals

Answer D.
A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to ingest liquids between meals rather than with meals. Taking fluids between meals allows for adequate hydration, reduces the amount of bulk ingested with meals, and aids in the prevention of rapid gastric emptying. There is no need to restrict the amount of fluids, just the time when the client drinks fluids. Drinking liquids with meals increases the risk of dumping syndrome by increasing the amount of bulk and stimulating rapid gastric emptying. Small amounts of water are allowable before meals.
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Gastrectomy and surgical operation consisting of partial or total resection of the stomach.
It can be used in malures stomach stomachs that belong to the ceruxía, the small benign tumors. In practice, the main applications are: complicated gastroduodenal ulcer (fury, hemorrhage, stenosis) and gastric carcinoma.

Tribes:
Radical Gastrectomy:
It consists of the extraction of stomach tol and the cellulo-lymphatic texts of the hall.
Suel faese on way in the presence of cancanu d'estomagu (gastric carcinoma).

Total Gastrectomy:
It consists of the removal of the stomach, from the cardies to the pylorus.
The stump d'esófagu xúnese directly to the ileu or the colon, and is progressively dilating, forming a kind of new stomach (neo-stomach).
There is a subtype that goes subtotal gastrectomy, with three purposes of operation:
- Gastroduodenostomy (Bilroth I): Xuniendo'l stump directly col cabu duodenu. It is the most physioxic variety.
- Gastroyejunostomy (Bilroth II or Anastomosis n'ω): Xuniendo'l tail stump convesidá d'una of the first intestinal aces, arranged in a way that forms the uppercase Greek omega lletra.
- Gastroyejunostomy n'Y of Roux: A stump d'stomagu xúnese to the cabu seicionáu d'a intestinal loop, which is duodenu xue'l duodenu llaterally to the intestinal loop.

Partial Gastrectomy:
It consists of a resection of a part of the stomach. Be carried out in selective pathological pictures of the constitutive text of the stomach, such as gastric or duodenal ulcer.
Resection almost always involves the elimination of the pylorus. Transition from the stomach to the intestine is secured by a gastroduodenostomy; more frequently, the xuenza faise tres of the stump of the stomach jejunu (Polya operation, Finsterer operation, Kocher operation, etc.).

Consequencies:
The total or subtotal lack of the stomach implies the lack of production of the gastric xugu, because the gastrectomy needs a particular diet, it must be particularly digestible and well divided throughout the day. Amás d'esto, can administer animal or vexetal proteolytic enzymes (trypsin, pepsin, bromelain, papain, etc.).

Nurse Abby is caring for a client with a brain tumor and increased intracranial pressure (ICP).. Administer stool softeners

Nurse Abby is caring for a client with a brain tumor and increased intracranial pressure (ICP). Which intervention should the nurse include in the plan of care to reduce ICP?
a- Encourage coughing and deep breathing
b- Position with head turned toward side of brain tumor
c- Administer stool softeners
d- Provide sensory stimulation

Answer C.
Stool softeners reduce the risk of straining during a bowel movement, which can increase ICP by raising intrathoracic pressure and interfering with venous return. Coughing also increases ICP. Keeping the head in midline and avoiding extreme neck flexion prevents obstruction of venous outflow from the brain. Both sensory stimulation and noxious stimuli can increase ICP.
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Stool softeners:
For what conditions or diseases is this medication prescribed?
Stool softeners are used in the short term to relieve constipation symptoms in those people who should avoid exerting much effort during bowel movements, as they suffer from heart disease, hemorrhoids and other problems. They work by softening the stool, which facilitates its evacuation.

How should this medicine be used?
Stool softeners come in the form of capsules, pills, liquid solution and syrup to take by mouth. Stool softeners are usually taken at bedtime. Follow the instructions on the medication label carefully and ask your doctor or pharmacist anything you do not understand. Use the medication exactly as directed. Do not use more or less than the indicated dose or more often than prescribed by your doctor.
Swallow docusate capsules whole; Do not divide, chew, or crush.
Take the capsules and pills with a large glass of water. The liquid solution comes with a specially marked dropper to measure the dose. If you have any problems using it, ask your pharmacist to show you how to use it. Mix the liquid solution (not the syrup) with 4 ounces of milk, fruit juice or breast milk or formula to hide its bitter taste.
It takes between one and three days of regular use for this medication to take effect. Do not take stool softeners for more than 1 week unless your doctor tells you. If sudden changes in the intestines last more than 2 weeks or if your stools are still hard after you have taken the medicine for a week, call your doctor.

What other uses does this medication have?
This medication may be prescribed for other uses; Ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before you start taking stool softeners:
- tell your doctor and pharmacist if you are allergic to any stool softener, any other medications, or any of the ingredients in stool softeners. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention mineral oil. Your doctor may need to change the dose of your medications or monitor you carefully for any side effects.
- tell your doctor if you are pregnant, have plans to get pregnant or if you are breastfeeding. If you become pregnant while taking this medication, call your doctor immediately.

What do I have to do if I forget to take a dose?
This medicine is taken as needed. If your doctor has told you to take stool softeners regularly, take the missed dose as soon as you remember, however, if it is time for the next one, skip the one you did not take and continue with the regular dosage. Do not take a double dose to make up for the one you forgot.

What are the side effects that this medicine could cause?
Although the side effects of stool softeners are not common, they may occur. Tell your doctor if any of these symptoms become severe or if it does not go away:
- cramps
- Stomach ache
- throat irritation (caused by oral liquid solution).

Some Side Effects Can Be Serious. If you experience any of the following symptoms, call your doctor immediately:
- rash
- hives
- difficulty breathing or swallowing
- fever
- vomiting
- stomach ache

How should I store or dispose of this medicine?

Keep this medicine in its container, tightly closed and out of the reach of children. Store it at room temperature and away from excessive heat and humidity (not in the bathroom).

It is important that you keep all medications out of the sight and reach of children, because many containers (such as weekly pill boxes, and those containing ophthalmic drops, creams, patches and inhalers) are not proof of small children, who can easily open them. In order to protect them from intoxication, always wear safety covers and immediately place medications in a safe place, one that is up and away from your sight and reach.

Medications that are no longer needed should be disposed of in an appropriate manner to ensure that pets, children and others cannot consume them. However, you should not discard these medications by the toilet. Instead, the best way to get rid of your medications is through a medication return program. Talk to your pharmacist or contact your local trash / recycling department to learn about your community's drug return programs. See the Food and Drug Administration (FDA) website for more information on how to safely dispose of medications if you do not have access to the medication return program.

What other important information should I know?

Ask the pharmacist any questions you have about how to take this medicine.

It is important that you keep a written list of all the medications you are taking, including those you received with a prescription and those you bought without a prescription, including vitamins and diet supplements. You should have the list every time you visit your doctor or when you are admitted to a hospital. It is also important information in emergencies.

Trademarks:

- Colace®

- Correctol Soft Gels®

- Diocto®

- Ex-Lax Stool Softener®

- Fleet Sof-Lax®

- Phillips' Liqui-Gels®

- Surfak®

Combined product trademarks:

- Correctol 50 Plus® (contains docusate, sennosides)

- Ex-Lax Gentle Strength® (contains docusate, sennosides)

- Gentlax S® (contains docusate, sennosides)

- Peri-Colace® (contains docusate, sennosides)

- Senokot S® (contains docusate, sennosides)

Other names:

- dioctyl calcium sulfosuccinate

- dioctyl sodium sulfosuccinate

- docusate calcium

- docusate sodium

- DOSS

- DSS.

A client is being admitted to the substance abuse unit for alcohol detoxification.. Begin anytime within the next 1 to 2 days

A client is being admitted to the substance abuse unit for alcohol detoxification. As part of the intake interview, the nurse asks him when he had his last alcoholic drink. He says that he had his last drink 6 hours before admission. Based on this response, nurse Willy should expect early withdrawal symptoms to:
a- Not occur at all because the time period for their occurrence has passed
b- Begin anytime within the next 1 to 2 days
c- Begin within 2 to 7 days
d- Begin after 7 days

Answer B.
Acute withdrawal symptoms from alcohol may begin 6 hours after the client has stopped drinking and peak 1 to 2 days later. Delirium tremens may occur 2 to 4 days — even up to 7 days — after the last drink.

Withdrawal symptoms:
When stopping or drastically reducing excessive and prolonged consumption of alcohol, withdrawal symptoms may occur. Their severity and duration can vary greatly, from the banal "hangover" to a deadly delirium tremens.
If you have been drinking heavily for a long time and withdrawal symptoms appear after reducing or stopping your alcohol consumption, it is strongly advised to consult your family doctor or other medical expert. Indeed, it is impossible to predict how your situation will evolve. A doctor may also prescribe supportive treatment, which alleviates withdrawal symptoms and limits risk.

The hangover:
- All people who have "drunk" a day, know what it is, and so those who drink moderately know it too. In the latter case, it is the effect of mild intoxication by alcohol. In heavy drinkers, the hangover can also be a partial withdrawal syndrome, caused by a sharp drop in the amount of alcohol in the body during sleep.
- Some excessive drinkers make up for these withdrawal symptoms by starting to drink early in the day. This is called "morning consumption".
- The severity of the hangover depends on the amount of alcohol absorbed, the type of drink (some drinks cause a hangover faster because of the substances they contain), individual sensitivity and physical condition and mental health of the person concerned.
- Symptoms: "general feeling of discomfort", fatigue, headache, "dry mouth", nausea, vomiting, dizziness, hypersensitivity to stimulation and sometimes anxiety, melancholy, guilt and remorse ("I will never drink again") ).

The symptoms of "uncomplicated" weaning:
- They begin to manifest usually 24 hours after the drastic reduction or cessation of excessive consumption of long-term alcohol.
- The main symptom is "tremulation" (tremors), especially of the hands, but sometimes also of the head and the tongue. It can range from slight tremors to strong tremor.
- The symptoms are similar to those of a hangover, but much more pronounced.
- Other symptoms: profuse sweating, accelerated pulse, sometimes also hyperventilation and hypertension. The person may also have severe agitation, irritability, sleep disturbances, nightmares, anxiety and depressed mood.
- There is often also a terrible "state of lack", that is to say, an irrepressible and consuming drive of alcohol consumption.
- Finally, there may be temporary confusion. The person may have perception disorders during which, for example, she "sees bugs". These symptoms usually do not last very long and the person is usually fully aware that what she sees or hears is not reality.
- These symptoms are not dangerous in themselves and usually disappear after 7 to 10 days of abstinence. After 24 hours, withdrawal symptoms peak and, after three days, the worst is over. However, dark thoughts and insomnia can persist for several weeks.

Clients with anorexia can refuse food to the point of cardiac damage. Tube feedings and I.V. infusions are ordered to prevent such damage

Jannah, a 15-year-old girl with anorexia has been admitted to a mental health unit. She refuses to eat. Which of the following statements is the best response from the nurse?
a. You don’t have to eat. It’s your choice
b. I hope you’ll eat your food by mouth. Tube feedings and I.V. lines can be uncomfortable
c. Why do you think you’re fat? You’re underweight. Here — look in the mirror
d. You really look terrible at this weight. I hope you’ll eat.

Answer B.
Clients with anorexia can refuse food to the point of cardiac damage. Tube feedings and I.V. infusions are ordered to prevent such damage. The nurse is informing her of her treatment options.

Anorexia nervosa is not just a normal disorder; it can have a significant negative effect on health, whether physical, mental or mental. Which requires rapid therapeutic and psychological intervention to treat the person who is affected by this disease, which controls his mind and health.

Causes of anorexia nervosa:
There are many reasons behind anorexia nervosa, which are as follows:
- Lack of self-confidence and dissatisfaction with the external shape of the body.
- psychiatric disturbances.
- Exposure to pressure by society.
- Dream of reaching ideal weight in any way possible.
- Genetic defect associated with family history.
- Pursuing a widely distributed stereotype about perfection and idealism.

Symptoms of anorexia nervosa:
Anorexia nervosa can cause many symptoms ranging from mild to serious:
- Significant weight loss.
- Turn the body.
- Fatigue and exhaustion in general.
- Permanent insomnia.
- The color of the fingers in the hands and feet.
- Hypertension and drought.
- dizziness and dizziness.
- Chronic constipation.
- Stop menstruation.
- Myocardial infarction.
- Swelling and swollen limbs.
- Hair loss and exposure to bombardment, weakness and color blemishes.
- Dry skin and skin peel.
This is for the symptoms of organic, either psychological symptoms include the following:
- Desire to isolate and stay away from others.
- Depression and permanent frustration.
- Permanent fear of increasing body weight.
- Excessive exercise to prevent weight gain.
- Refrain from eating.
- Lack of sexual life and loss of desire to establish intimacy.
- Follow strict diets and diets to lose weight permanently.

Treatment of anorexia nervosa:
If the above symptoms persist and persist for a long time, you must immediately seek the appropriate physician who will make the necessary diagnosis to indicate the health status of the person with anorexia nervosa and how to treat it.
The doctor usually performs some necessary tests, such as measuring body weight, height, blood pressure, blood sugar, heart rate, body temperature and all vital processes in the body.

Which nursing action is most appropriate for a client hospitalized with acute pancreatitis.. Withholding all oral intake, as ordered, to decrease pancreatic secretions

Which nursing action is most appropriate for a client hospitalized with acute pancreatitis?
a. Withholding all oral intake, as ordered, to decrease pancreatic secretions
b. Administering morphine, as prescribed, to relieve severe pain
c. Limiting I.V. fluids, as ordered, to decrease cardiac workload
d. Keeping the client supine to increase comfort

Answer A.
The nurse should withhold all oral intake to suppress pancreatic secretions, which may worsen pancreatitis. Typically, this client requires a nasogastric tube to decompress the stomach and GI tract. Although pancreatitis may cause considerable pain, it’s treated with I.M. meperidine (Demerol), not morphine, which may worsen pain by inducing spasms of the pancreatic and biliary ducts. Pancreatitis places the client at risk for fluid volume deficit from fluid loss caused by increased capillary permeability. Therefore, this client needs fluid resuscitation, not fluid restriction. A client with pancreatitis is most comfortable lying on the side with knees flexed.

A client with burns on his groin has developed blisters. As the client is bathing, a few blisters break.. clean the area with normal saline solution and cover it with a gauze dressing

A client with burns on his groin has developed blisters. As the client is bathing, a few blisters break. The best action for nurse Ashley to take would be to:
a. remove the raised skin because the blister has already broken
b. wash the area with soap and water to disinfect it
c. apply a weakened alcohol solution to clean the area
d. clean the area with normal saline solution and cover it with a gauze dressing

Answer D.
The nurse should clean the area with a mild solution such as normal saline, and then cover it with a protective dressing. Soap and water and alcohol are too harsh. The body’s first line of defense has been broken when the blisters opened; removing the skin exposes a larger area to the risk of infection.

A preschool-age child underwent a tonsillectomy 4 hours ago. assessment finding would make nurse suspect postoperative hemorrhage

A preschool-age child underwent a tonsillectomy 4 hours ago. Which assessment finding would make nurse Jennifer suspect postoperative hemorrhage?
a. Vomiting of dark brown emesis
b. Refusal to drink clear fluids
c. Decreased heart rate
d. Frequent swallowing

Answer D.
Frequent swallowing - an attempt to clear the throat of trickling blood - suggests postoperative hemorrhage. Emesis may be brown or blood-tinged after a tonsillectomy; only bright red emesis signals hemorrhage. The child may refuse fluids because of painful swallowing, not bleeding. Hemorrhage is associated with an increased, not decreased, heart rate.

Which nursing diagnosis takes highest priority for a client with Parkinson’s crisis.. Ineffective airway clearance

Which nursing diagnosis takes highest priority for a client with Parkinson’s crisis?
a. Imbalanced nutrition: Less than body requirements
b. Ineffective airway clearance
c. Impaired urinary elimination
d. Risk for injury

Answer B.
In Parkinson’s crisis, dopamine-related symptoms are severely exacerbated, virtually immobilizing the client. A client confined to bed during such a crisis is at risk for aspiration and pneumonia. Also, excessive drooling increases the risk of airway obstruction. Because of these concerns, the nursing diagnosis of Ineffective airway clearance takes highest priority. Although the other options also are appropriate, they aren’t immediately life-threatening.

Which nursing diagnosis takes highest priority for a client with hyperthyroidism.. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

Which nursing diagnosis takes highest priority for a client with hyperthyroidism?
a. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
b. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
c. Body image disturbance related to weight gain and edema
d. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

Answer D.
In the client with hyperthyroidism, excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance, increased protein synthesis and breakdown, decreased glucose tolerance, and fat mobilization and depletion. This puts the client at risk for marked nutrient and calorie deficiency, making Imbalanced nutrition: Less than body requirements the most important nursing diagnosis.