A construction worker arrives at an urgent care center with a ...

[dollx]

A construction worker arrives at an urgent care center with a deep puncture wound after an old nail penetrated his boot.. The patient reports having had a tetanus booster 6 years ago. The nurse will anticipate
 
  a. IV infusion of tetanus immune globulin (TIG).
  b. administration of the tetanus-diphtheria (Td) booster.
  c. intradermal injection of an immune globulin test dose.
  d. initiation of the tetanus-diphtheria immunization series.

Question 2

A 68-year-old patient hospitalized with a new diagnosis of Guillain-Barr syndrome has numbness and weakness of both feet. The nurse will anticipate teaching the patient about
 
  a. intubation and mechanical ventilation.
  b. administration of corticosteroid drugs.
  c. insertion of a nasogastric (NG) feeding tube.
  d. infusion of immunoglobulin (Sandoglobulin).

[micaelaswann]

Answer to Question 1

ANS: B
If the patient has not been immunized within 5 years, administration of the Td booster is indicated because the wound is deep. Immune globulin administration is given by the IM route if the patient has no previous immunization. Administration of a series of immunization is not indicated. TIG is not indicated for this patient, and a test dose is not needed for immune globulin.

Answer to Question 2

ANS: D
Because the Guillain-Barr syndrome is in the earliest stages (as evidenced by the symptoms), use of high-dose immunoglobulin is appropriate to reduce the extent and length of symptoms. Mechanical ventilation and tube feedings may be used later in the progression of the syndrome but are not needed now. Corticosteroid use is not helpful in reducing the duration or symptoms of the syndrome.

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Gracias!

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