The nurse is caring for an immunosuppressed pediatric client who reports soreness in his mouth and refuses to eat. Inspection of his mouth reveals a white, milky plaque that does not come off with rubbing. The nurse should anticipate which drug to be administered to this client?
nystatin (Mycostatin)
amoxicillin (Amoxil)
metronidazole (Flagyl)
acyclovir (Zovirax)
The Correct Answer is A
A. Nystatin is an antifungal medication used to treat oral candidiasis (thrush), which is consistent with the client's symptoms of soreness in the mouth and the presence of a white, milky plaque that does not rub off.
B. Amoxicillin is an antibiotic that treats bacterial infections but would not be effective against fungal infections like oral thrush.
C. Metronidazole is an antibiotic and antiprotozoal medication, which is not appropriate for treating oral candidiasis.
D. Acyclovir is an antiviral medication used to treat infections caused by certain viruses, such as herpes, and is not effective for fungal infections like thrush.
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Correct Answer is B
Explanation
A. Diarrhea is not a direct risk of stopping TPN abruptly.
B. Abruptly stopping TPN can cause hypoglycemia because the high glucose content in TPN leads to increased insulin production. Without the continuous glucose infusion, blood sugar levels can drop rapidly.
C. Hypovolemia is not a common outcome from stopping TPN suddenly.
D. Erythema at the site is unrelated to the cessation of TPN and more commonly related to local site reactions or infection.
Correct Answer is C
Explanation
A. A pulse oximetry of 92% indicates mild hypoxia but does not directly contraindicate the use of verapamil.
B. A respiratory rate of 12 is within the normal range for adults and does not indicate a need to hold the medication.
C. A pulse of 78 is within the normal range but should be assessed in the context of the client’s overall condition; however, if the pulse were significantly lower (e.g., <60 bpm), it would necessitate holding the medication due to the risk of bradycardia.
D. A history of myocardial infarction a week ago would warrant caution but is not an absolute reason to hold verapamil unless other contraindications are present, as verapamil can be beneficial for managing hypertension post-MI.