A patient is diagnosed with a pulmonary embolism. Which of the following treatments should the nurse anticipate?
Initiation of a high-sodium diet
Application of a cast to the affected limb
Administration of anticoagulant therapy
Administration of bronchodilators
The Correct Answer is C
A. Initiation of a high-sodium diet. A high-sodium diet is not indicated in pulmonary embolism management; it could worsen fluid retention and cardiovascular strain.
B. Application of a cast to the affected limb. Casting is not appropriate for pulmonary embolism, as it is not an orthopedic injury. Immobilization could increase the risk of further clot formation.
C. Administration of anticoagulant therapy. Anticoagulant therapy, such as heparin or warfarin, is the primary treatment for pulmonary embolism to prevent further clot formation and allow the body to dissolve the clot.
D. Administration of bronchodilators. Bronchodilators may alleviate respiratory symptoms but do not treat the underlying clot in pulmonary embolism. Anticoagulation remains the primary treatment.
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Correct Answer is A
Explanation
A. Serum sodium levels: Desmopressin can lead to water retention and potentially hyponatremia. Monitoring serum sodium is crucial to prevent electrolyte imbalance.
B. Serum magnesium levels: Magnesium is not typically impacted by desmopressin treatment in central diabetes insipidus.
C. Serum potassium levels: Desmopressin does not generally affect potassium levels in patients with diabetes insipidus.
D. Serum calcium levels: Calcium levels are not directly influenced by desmopressin or diabetes insipidus.
Correct Answer is B
Explanation
A. Keep the patient NPO (nothing by mouth) until the T-tube is removed. Patients are generally kept NPO initially but may resume clear liquids and progress to a regular diet based on tolerance; NPO status is not required until the T-tube is removed.
B. Monitor the tube drainage and document the amount and color. Monitoring and documenting drainage from the T-tube is crucial to assess biliary function and ensure that the bile is draining properly, indicating no obstruction.
C. Ensure the tube is clamped for 8 hours each day. Clamping may be done before tube removal to test the body’s tolerance to bile drainage, but it should be done only as per physician orders, not routinely for 8 hours each day.
D. Flush the T-tube with normal saline every 4 hours. Flushing a T-tube is generally not done routinely as it could disrupt the flow of bile and cause complications.