Author Question: In obtaining a past history as part of a history of present illness (HPI), the nurse asks the client ... (Read 149 times)

MGLQZ · **on:** Jun 25, 2018

In obtaining a past history as part of a history of present illness (HPI), the nurse asks the client about allergies to drugs, animals, insects, and other environmental agents.

In addition to this information and asking about how the reaction is treated, which is the most important allergy-related information that the nurse should inquire about?
1. The location where the reaction occurred.
2. The type of reaction that occurred with exposure.
3. Exactly how long the symptoms lasted.
4. Immediate and extended family members with the same allergy.

Question 2

The nurse is examining a client with congestive heart failure who takes propranolol and furosemide. The client complains of fatigue and an inability to finish tasks. Which conclusion by the nurse is the most appropriate?

1. The medication needs adjustment.
2. The client has not been exercising.
3. The client is experiencing expected manifestations of the disease process.
4. The client should be hospitalized.

scottmt · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 2
In addition to identifying the specific allergen to which the client is allergic (that is, drugs, animals, insects, environmental agents) and how the reaction is treated, the nurse should always ask about the type of reaction that occurs with exposure to the allergen. What occurs with exposure is especially important in order to be able to help identify the severity of any potential exposure as well as to obtain a better understanding of an individual's perspective of what constitutes an allergy. For example, the implications of a client telling the nurse that he or she has an anaphylactic reaction to bee stings or to penicillin differs from the implications of a client who reports an allergy to mosquito bites, which become reddened and itch. The location where the reaction occurred might be helpful in discerning the potential cause of current signs and symptoms of allergies and how long the symptoms lasted (e.g., recently visiting a relative who has several cats with symptoms improving upon leaving the home), but what reaction occurs with exposure has greater importance than this information when asking about past history. Similarly, knowing that family members have the same allergy is not as critical as discerning what occurs with exposure to various allergens.

Answer to Question 2

Correct Answer: 3
Heart failure and the drugs prescribed for it cause the client to be fatigued. Although this would be considered abnormal in most clients, it is expected in the client with heart failure. The client does not need to be hospitalized for fatigue. Fatigue is not an indication that the medication needs adjusting. A lack of exercise would not cause the client to experience fatigue severe enough to prevent the completion of tasks.