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 B
Explanation
Rationale:
A. Mostly cloudy: This option does not refer to a medication and is therefore irrelevant in this context.
B. Acyclovir: This is the correct medication for treating varicella-zoster virus, as it is an antiviral drug effective in managing symptoms and reducing the duration of the infection.
C. Vancomycin: This antibiotic is used to treat serious bacterial infections and is not indicated for viral infections like varicella-zoster.
D. Gentamicin: This is an aminoglycoside antibiotic that is ineffective against viral infections and is used primarily for bacterial infections.
E. Quinine: This medication is used to treat malaria and is not relevant for varicella-zoster virus treatment.
Correct Answer is D
Explanation
Rationale:
A. Mostly cloudy: This option appears to be incorrectly stated. It does not pertain to a critical client assessment related to morphine administration.
B. Apical heart rate: Monitoring the heart rate is important, but respiratory depression is a more immediate and life-threatening concern with morphine administration, so it is not the first priority.
C. Blood pressure: Morphine can cause hypotension, but this is not as critical as respiratory depression, which must be assessed first in opioid administration.
D. Respiratory rate: The most critical assessment when administering morphine is the respiratory rate, as opioid medications like morphine can cause respiratory depression, which can be life-threatening if not addressed.
E. Level of consciousness: While important, changes in consciousness typically follow respiratory depression, so assessing the respiratory rate takes priority.