A client who is newly diagnosed with erosive esophagitis secondary to gastroesophageal reflux disease (GERD) reports to the nurse that they did not notice any reduction in symptoms after taking lansoprazole PO for one full week. Which action should the nurse take?
Notify the healthcare provider that the client may need a change in dosage.
Auscultate the client’s bowel sounds and measure the abdominal girth.
Advise the client that healing typically takes several weeks to occur.
Confirm that the client is taking the medication one hour after meals.
The Correct Answer is C
Choice A rationale
Lansoprazole, a proton pump inhibitor (PPI), typically requires several weeks to achieve its full therapeutic effect. Notifying the healthcare provider for a dosage change after only one week is premature and not supported by clinical guidelines.
Choice B rationale
Auscultating bowel sounds and measuring abdominal girth are not directly related to the effectiveness of lansoprazole in treating GERD. These actions are more relevant for assessing gastrointestinal motility and potential complications like bowel obstruction.
Choice C rationale
Healing of erosive esophagitis with PPIs like lansoprazole usually takes several weeks. Advising the client that healing typically takes several weeks to occur is appropriate and aligns with the expected therapeutic timeline.
Choice D rationale
Lansoprazole should be taken before meals, not after, to maximize its effectiveness. Confirming that the client is taking the medication one hour after meals would not address the issue of symptom persistence.
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Correct Answer is A
Explanation
Choice A rationale
For long-term control of normal eye pressure is the accurate response. Open-angle glaucoma is a chronic condition that requires ongoing treatment to maintain normal intraocular pressure and prevent further damage to the optic nerve. Eye drops are typically used for life to manage the condition.
Choice B rationale
Until a smaller angle can be restored is not accurate because open-angle glaucoma does not involve a change in the angle of the anterior chamber. The goal of treatment is to lower intraocular pressure, not to restore the angle.
Choice C rationale
For long-term control of pain and swelling is not accurate because open-angle glaucoma primarily involves increased intraocular pressure and optic nerve damage, not pain and swelling. The goal of treatment is to lower intraocular pressure.
Choice D rationale
Until the excess pressure is reduced is not accurate because open-angle glaucoma requires ongoing treatment to maintain normal intraocular pressure. Stopping treatment once pressure is reduced can lead to a recurrence of elevated pressure and further damage.
Correct Answer is ["A","D"]
Explanation
Choice A rationale:
Enalapril is an ACE inhibitor used to manage hypertension. While it is generally safe, in the context of pneumonia, it can potentially cause complications such as hypotension, especially if the patient becomes septic or dehydrated. Additionally, ACE inhibitors can cause a persistent cough, which might be confused with or exacerbate the symptoms of pneumonia.
Choice B rationale:
Admitting the patient to the medical floor is appropriate given the diagnosis of pneumonia and the patient’s symptoms. Hospitalization allows for close monitoring and administration of necessary treatments.
Choice C rationale:
Sending blood for a complete blood count and electrolytes is standard practice to assess the patient’s overall health and identify any potential complications such as electrolyte imbalances or infection severity.
Choice D rationale:
Supplemental oxygen at 10 L/min via nasal cannula is quite high and typically not the first choice for pneumonia patients. High-flow oxygen therapy or non-invasive ventilation might be more appropriate if the patient requires such high levels of oxygen. Generally, nasal cannulas are used for lower flow rates (up to 6 L/min), and higher flow rates can cause discomfort and nasal dryness.
Choice E rationale:
Ibuprofen is commonly used to manage fever and pain in pneumonia patients. It helps reduce fever and alleviate discomfort, which can improve the patient’s overall condition.
Choice F rationale:
Continuous pulse oximetry is appropriate for monitoring the patient’s oxygen saturation levels, especially given the initial low oxygen saturation on room air.
Choice G rationale:
Vital signs every 4 hours is a standard practice for monitoring patients with pneumonia to detect any changes in their condition promptly.
Choice H rationale:
A chest X-ray is essential for diagnosing and assessing the extent of pneumonia. It helps in identifying the presence of infiltrates, consolidation, or other complications.