The nurse is reviewing the medical records for five patients who ...

[washai]

The nurse is reviewing the medical records for five patients who are scheduled for their yearly physical examinations in September. Which patients should receive the inactivated influenza vaccination (select all that apply)?
 
  a. A 76-year-old nursing home resident
  b. A 36-year-old female patient who is pregnant
  c. A 42-year-old patient who has a 15 pack-year smoking history
  d. A 30-year-old patient who takes corticosteroids for rheumatoid arthritis
  e. A 24-year-old patient who has allergies to penicillin and cephalosporins

Question 2

A patient arrives in the ear, nose, and throat clinic complaining of a piece of tissue being stuck up my nose and with foul-smelling nasal drainage from the right nare. Which action should the nurse take first?
 
  a. Notify the clinic health care provider.
  b. Obtain aerobic culture specimens of the drainage.
  c. Ask the patient about how the cotton got into the nose.
  d. Have the patient occlude the left nare and blow the nose.

[Rilsmarie951]

Answer to Question 1

ANS: A, B, D
Current guidelines suggest that healthy individuals between 6 months and age 49 receive intranasal immunization with live, attenuated influenza vaccine. Individuals who are pregnant, residents of nursing homes, or are immunocompromised or who have chronic medical conditions should receive inactivated vaccine by injection. The corticosteroid use by the 30-year-old increases the risk for infection.

Answer to Question 2

ANS: D
Because the highest priority action is to remove the foreign object from the nare, the nurse's first action should be to assist the patient to remove the object. The other actions are also appropriate but should be done after attempting to clear the nose.

[washai]

Excellent

[bdobbins]

Gracias!