A client is in the hospital and receiving IV antibiotics. When ...

[theo]

A client is in the hospital and receiving IV antibiotics. When the nurse answers the client's call light, the client presents an appearance as shown below:
 
  What action by the nurse takes priority?
  a.
  Administer epinephrine 1:1000, 0.3 mg IV push immediately.
  b.
  Apply oxygen by facemask at 100 and a pulse oximeter.
  c.
  Ensure a patent airway while calling the Rapid Response Team.
  d.
  Reassure the client that these manifestations will go away.

Question 2

A nurse has educated a client on an epinephrine auto-injector (EpiPen). What statement by the client indicates additional instruction is needed?
 
  a. I don't need to go to the hospital after using it.
  b. I must carry two EpiPens with me at all times.
  c. I will write the expiration date on my calendar.
  d. This can be injected right through my clothes.

[carlsona147]

Answer to Question 1

ANS: C
The nurse should ensure the client's airway is patent and either call the Rapid Response Team or delegate this to someone else. Epinephrine needs to be administered right away, but not without a prescription by the physician unless standing orders exist. The client may need oxygen, but a patent airway comes first. Reassurance is important, but airway and calling the Rapid Response Team are the priorities.

Answer to Question 2

ANS: A
Clients should be instructed to call 911 and go to the hospital for monitoring after using the EpiPen. The other statements show good understanding of this treatment.

[theo]

TYSM

[lcapri7]

Gracias!