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A nurse is reviewing the medication administration record (MAR) of a client who requires fluticasone MDI one puff and albuterol MDI two puffs. Which of the following actions should the nurse plan to take? Place the following steps in the correct order. (Move the steps into the box on the right, placing them in the selected order of performance. All steps must be used.)

A.

Have the client take one puff of albuterol

B.

Have the client rest for 1 min

C.

Have the client take the second puff of albuterol

D.

Have the client rest for 5 min

E.

Have the client take one puff of fluticasone

Answer and Explanation

The Correct Answer is A, B, C, D, E

Rationale:

  • Administering albuterol first is crucial because it is a bronchodilator that will help open the airways before administering the anti-inflammatory fluticasone.

 

  • The client should rest for 1 minute between puffs of albuterol to allow for the medication to take effect.

 

  • After taking the second puff of albuterol, a longer rest of 5 minutes allows the client to experience the full effects of the bronchodilator.

 

  • Finally, administering fluticasone afterward will help reduce inflammation in the airways, maximizing the benefit of both medications.


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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.

Correct Answer is A

Explanation

Rationale:

A. Requesting a serum trough level blood draw for 60 minutes after the completion of the infusion is appropriate for monitoring the therapeutic levels of vancomycin and ensuring it is within the desired range to prevent toxicity.

B. Changing the infusion site after each dose administration is not necessary unless there is an issue such as infiltration or phlebitis; typically, the site can be used for multiple doses if it remains patent and functional.

C. Contacting the provider for prescription clarification is not needed unless there are specific concerns about the medication or the administration protocol; in this case, the order is clear and standard.

D. Requesting a serum peak level to be drawn 30 minutes prior to infusion is incorrect, as the peak level should be drawn 30 minutes after the completion of the infusion, not before the next dose.

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