A nurse is caring for a client who refused a prescribed dose of valproic acid 250 mg PO. The client states, "I don't want to take that pill because it makes me feel nauseated." Which of the following actions should the nurse take? (Select all that apply.)
Educate the client about the possible consequences of not taking the medication.
Suggest the client take food with the medication to minimize GI effects.
Document the client's refusal in the medication administration record.
Offer to administer the medication IM.
Recommend the client ask the provider to prescribe an enteric-coated medication.
Correct Answer : A,B,C,E
Rationale:
A. Educating the client about the consequences of not taking valproic acid is essential to ensure they understand the importance of adherence to the medication regimen.
B. Suggesting that the client take the medication with food can help minimize gastrointestinal side effects such as nausea.
C. Documenting the client's refusal in the medication administration record is a critical step to maintain accurate medical records and to inform other healthcare providers.
D. Offering to administer the medication IM is not appropriate, as valproic acid is typically given orally and not via intramuscular injection.
E. Recommending the client ask the provider about an enteric-coated formulation may provide a more tolerable option to reduce gastrointestinal side effects.
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Correct Answer is C
Explanation
Rationale:
A. Furosemide is a diuretic that promotes urine production but is not indicated for treating bladder distention or urinary retention post-surgery.
B. Lorazepam is an anxiolytic medication and does not address urinary retention or bladder distention.
C. Bethanechol is a cholinergic agent that stimulates bladder contraction and is used to treat urinary retention. It helps to facilitate voiding in clients who have difficulty.
D. Atropine is an anticholinergic medication that can actually inhibit bladder contraction, making it inappropriate for this situation.
Correct Answer is D
Explanation
Rationale:
A. Ganciclovir: Ganciclovir is an antiviral medication used primarily to treat viral infections such as cytomegalovirus (CMV), not bacterial infections like UTIs.
B. Amphotericin B: Amphotericin B is an antifungal agent used to treat serious fungal infections, not bacterial UTIs.
C. Azithromycin: Azithromycin is an antibiotic that is effective against a broad range of bacterial infections but is not commonly used for treating recurrent UTIs.
D. Nitrofurantoin: Nitrofurantoin is an antibiotic commonly used to prevent and treat recurrent lower urinary tract infections due to its efficacy in targeting the bacteria that typically cause UTIs.