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A nurse is caring for a client who has a systemic fungal infection and is receiving IV amphotericin B deoxycholate. During previous infusions, the client developed a fever and chills. Which of the following actions should the nurse take?

A.

Apply a warming blanket prior to administration.

B.

Infuse the medication over 1 hr.

C.

Administer diphenhydramine prior to administration.

D.

Monitor vital signs once per hour following administration.

Answer and Explanation

The Correct Answer is C

Rationale:

 

A. Applying a warming blanket is not appropriate, as it may exacerbate the client's reaction to the infusion and is not a standard pre-medication strategy.

 

B. Infusing amphotericin B deoxycholate over 1 hour is too rapid; it is typically infused over 2-6 hours to minimize adverse effects.

 

C. Administering diphenhydramine prior to the administration of amphotericin B can help prevent or alleviate infusion-related reactions such as fever and chills, which the client experienced during previous infusions.

 

D. Monitoring vital signs once per hour following administration is insufficient; vital signs should be monitored more frequently during and immediately after the infusion to promptly detect and address any adverse reactions.


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View Related questions

Correct Answer is ["A","D","E"]

Explanation

Rationale:

A. Blurred vision is a common side effect of anticholinergic medications due to their effect on the eye muscles and pupil dilation.

B. Polyuria is not typically associated with anticholinergic medications; these medications may actually lead to urinary retention.

C. A productive cough is not an expected adverse effect of anticholinergic medications; instead, they may cause dry mucous membranes and a dry cough.

D. Tachycardia can occur as anticholinergic medications block the effects of acetylcholine on the heart, leading to increased heart rate.

E. Constipation is a well-known side effect of anticholinergic medications because they reduce gastrointestinal motility.

Correct Answer is C

Explanation

Rationale:

A. Muscle rigidity of the extremities: This finding is more indicative of hyperkalemia or severe electrolyte imbalances but is not a common symptom of hypokalemia.

B. Bounding radial pulses: This finding is more associated with hypervolemia or hyperkalemia, not with hypokalemia caused by furosemide.

C. Depressed deep tendon reflexes: This is the correct response, as low potassium levels (hypokalemia) can lead to diminished reflexes due to its role in neuromuscular function.

D. Increased bowel motility: This is incorrect, as hypokalemia typically results in decreased bowel motility and may cause constipation rather than increased motility.

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