Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?
Reported history of alcoholism.
Toenails appear thick and yellow.
Employed as a construction worker.
White blood cell count of 8,500/mm³ (8.5 x 10⁹/L).
The Correct Answer is A
Choice A rationale
Reported history of alcoholism is the most important assessment finding to address before administering terbinafine HCL. Terbinafine is metabolized by the liver, and clients with a history of alcoholism may have impaired liver function, increasing the risk of hepatotoxicity. Monitoring liver function and assessing for signs of liver damage are crucial before starting treatment.
Choice B rationale
Toenails appear thick and yellow is a common symptom of fungal toenail infection, but it is not the most critical assessment finding to address before administering terbinafine HCL. The focus should be on assessing liver function.
Choice C rationale
Employed as a construction worker is not the most critical assessment finding to address before administering terbinafine HCL. While occupational exposure to fungi may be relevant, the primary concern is liver function.
Choice D rationale
White blood cell count of 8,500/mm³ (8.5 x 10⁹/L) is within the normal range and is not the most critical assessment finding to address before administering terbinafine HCL. The primary concern is liver function.
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View Related questions
Correct Answer is A
Explanation
Choice A rationale
Asking the client to describe the pain is the best approach to assess the quality of pain. This allows the nurse to gather detailed information about the pain’s characteristics.
Choice B rationale
Identifying effective pain relief measures is important but does not directly assess the quality of pain.
Choice C rationale
Observing body language and movement can provide clues about pain but is not as effective as directly asking the client to describe the pain.
Choice D rationale
Providing a numeric pain scale helps quantify the pain but does not provide detailed information about the pain’s quality.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale:
A computerized tomography (CT) scan of the chest is not typically required for routine pneumonia cases unless there are complications or the pneumonia is not responding to standard treatment. CT scans provide more detailed images but are usually reserved for more complex cases.
Choice B rationale:
Albuterol treatments by nebulizer every 4 to 6 hours are appropriate for managing wheezing and bronchospasm associated with pneumonia, especially in a patient with a history of COPD. Albuterol helps open the airways, making it easier for the patient to breathe.
Choice C rationale:
A chest x-ray is a standard diagnostic tool for pneumonia. It helps assess the extent of lung involvement and monitor the progression or resolution of the infection. Repeating the chest x-ray can help evaluate the effectiveness of the treatment.
Choice D rationale:
Increasing oral fluids is essential for patients with pneumonia to help thin mucus, making it easier to expectorate. Adequate hydration also supports overall health and recovery.
Choice E rationale:
Obtaining an arterial blood gas (ABG) is important for assessing the patient’s oxygenation and acid-base status. This information is crucial for managing respiratory distress and ensuring adequate oxygen delivery.