A nurse is caring for a client who requires a transfusion of one unit of packed RBCs. The nurse receives the following prescription: “Diphenhydramine 50 mg by mouth once, one hour prior to transfusion.”. The nurse should identify this as which of the following types of prescription?
Standing prescription.
Stat prescription.
Single prescription.
PRN prescription.
The Correct Answer is C
Choice A rationale
A standing prescription is an order that applies to all patients who meet certain criteria and is not specific to a single administration. It is used for routine treatments and does not apply to a one-time pre-transfusion medication.
Choice B rationale
A stat prescription is an urgent order that requires immediate administration, typically within minutes. It is used for emergency situations and does not apply to a pre-transfusion medication given one hour before the procedure.
Choice C rationale
A single prescription is a one-time order for a specific medication to be given at a specific time. In this case, diphenhydramine 50 mg by mouth once, one hour prior to transfusion, fits the definition of a single prescription.
Choice D rationale
A PRN (pro re nata) prescription is an order for medication to be given as needed based on the patient’s condition. It is not applicable to a scheduled pre-transfusion medication.
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Correct Answer is B
Explanation
Choice A rationale
Methimazole does not typically cause constipation. It is used to treat hyperthyroidism by inhibiting the production of thyroid hormones.
Choice B rationale
A sore throat can be a sign of agranulocytosis, a serious side effect of methimazole that involves a dangerously low white blood cell count. Patients are advised to contact their provider if they experience a sore throat.
Choice C rationale
While monitoring weight is important for patients with hyperthyroidism, it is not a specific instruction related to methimazole use.
Choice D rationale
Methimazole should be taken regularly as prescribed, not on an as-needed basis.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale:
The client’s temperature has decreased from 37.8°C (100°F) to 37.2°C (99°F). While this is a slight reduction, it indicates a move towards a more normal body temperature. Elevated temperatures can be associated with stress, anxiety, or other underlying conditions. A decrease in temperature suggests that the client’s body is stabilizing and that any potential underlying issues causing the elevated temperature are being managed effectively.
Choice B rationale:
The client’s mood has improved as she appears less anxious and more composed during the physical examination. Anxiety can significantly impact a person’s overall well-being, and a reduction in anxiety levels is a positive indicator of improvement. The client also expresses optimism about her recovery, which is a good sign of mental health improvement.
Choice C rationale:
The client has gained weight, increasing from 53 kg (117 lb) to 55 kg (121 lb). Weight gain in this context is a positive sign, indicating that the client’s body is responding well to treatment and that her nutritional status is improving. Unintentional weight loss can be a symptom of underlying health issues, so reversing this trend is a good indicator of recovery.
Choice D rationale:
The client reports better sleep, which is a significant improvement from her previous insomnia. Sleep is crucial for physical and mental health, and improved sleep patterns can lead to better overall health outcomes. Insomnia can exacerbate anxiety and other health issues, so better sleep is a positive sign.
Choice E rationale:
The client’s heart rate has decreased from 120/min to 95/min. A high heart rate can be a sign of anxiety, stress, or other health issues. A reduction in heart rate indicates that the client’s anxiety levels are decreasing and that her cardiovascular system is stabilizing. This is a positive sign of improvement in her overall health.
Choice F rationale:
The client's abdominal findings remained normal from the initial to the follow-up visit, so this does not indicate improvement. These findings were normal to begin with and have stayed unchanged.