A nurse is caring for a school-age child who is taking valproic acid. The nurse should expect the provider to order which of the following diagnostic tests?
ABGs
Serum liver enzyme levels
Chest X-ray
Urine culture and sensitivity
The Correct Answer is B
Rationale:
A. Arterial blood gases (ABGs) are typically used to assess respiratory function and acid-base balance, which are not primary concerns with valproic acid use.
B. Serum liver enzyme levels are critical to monitor due to the risk of hepatotoxicity associated with valproic acid therapy, making this test essential for safe management.
C. A chest X-ray is generally used to assess respiratory conditions, not relevant for monitoring the effects of valproic acid.
D. Urine culture and sensitivity are used to diagnose urinary tract infections and are not relevant to the monitoring of valproic acid therapy.
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Correct Answer is D
Explanation
Rationale:
A. A dry cough is not a common adverse effect associated with ibuprofen and is more related to respiratory issues.
B. An increase in urine output is not a typical adverse effect of ibuprofen; rather, it may indicate a different condition.
C. Muscle stiffness is a symptom of juvenile idiopathic arthritis itself and not specifically an adverse effect of ibuprofen.
D. Asking about stomach pain or bloody stools is crucial as ibuprofen can cause gastrointestinal irritation, ulcers, or bleeding, which are serious adverse effects of long-term use.
Correct Answer is B
Explanation
Rationale:
A. Attaching the NG tube to low intermittent suction is not recommended during gastric lavage, as suctioning can remove the lavage solution before it has a chance to work effectively.
B. Instilling the lavage solution in volumes of 500 mL at a time is correct as it allows for effective cleansing of the stomach and can help to clear out any blood or debris present.
C. Chilled lavage solution should not be used; it is recommended to use room temperature or warmed solution to avoid discomfort and potential complications such as cramping.
D. While 0.9% sodium chloride is isotonic and can be used for irrigation, it is not typically the solution used for gastric lavage; water or a specific lavage solution is more appropriate.