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 B
Explanation
Rationale:
A. Surgical asepsis (sterile technique) should be used for suctioning to prevent infection, not medical asepsis.
B. Applying suction for no longer than 10 seconds is appropriate to prevent hypoxia and trauma to the airway.
C. Advancing the catheter 2 cm after resistance is met is not advised; the catheter should not be forced beyond resistance to avoid injury.
D. The catheter should not be withdrawn if the client begins coughing; instead, it indicates the need for suctioning. If coughing occurs, the nurse should ensure the patient can breathe and may need to suction carefully.
Correct Answer is D
Explanation
Rationale:
A. Bradycardia is not typically associated with pulmonary edema; instead, tachycardia is more common as the body tries to compensate for decreased oxygenation.
B. Wheezing may occur in certain respiratory conditions but is not a classic finding in pulmonary edema; instead, crackles or rales are more expected due to fluid accumulation.
C. Pale, dry skin is not characteristic of pulmonary edema; the client may present with cyanosis or clammy skin due to hypoxia.
D. Pink, frothy sputum is a classic sign of pulmonary edema, indicating fluid in the alveoli and is often associated with acute heart failure.