Author Question: A nurse is caring for an older adult patient during the immediate postoperative period after a total ... (Read 74 times)

oliviahorn72 · **on:** Jul 23, 2018

A nurse is caring for an older adult patient during the immediate postoperative period after a total hip replacement. The surgeon has ordered meperidine (Demerol) for severe pain. What will the nurse do?

a. Administer the medication as prescribed and initiate a fall risk protocol.
b. Ask for a PRN order for diphenhydramine (Benadryl) for the expected side effect of itching.
c. Request an order for morphine instead of meperidine (Demerol).
d. Suggest to the surgeon that the patient receive diazepam (Valium) to reduce anxiety and the need for narcotics.

Question 2

A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications?

a. Glucocorticoids
b. Salicylates
c. Sulfonamides
d. Tetracyclines

Juro · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
In older adults, meperidine is not effective at usual doses and causes more confusion than in younger patients. Morphine is recommended for severe pain. A fall risk protocol is appropriate, but the drug ordered is not. Diphenhydramine is not recommended for older adult patients, because it causes blurred vision. Both diphenhydramine and diazepam have central nervous system (CNS) sedative effects, which will compound the CNS effects of the narcotic. Diazepam also produces prolonged sedation in older adults.

Answer to Question 2

ANS: D
Tetracyclines cause discoloration in developing teeth in children. Glucocorticoids are associated with growth suppression. Salicylates are associated with Reye's syndrome. Sulfonamides are associated with kernicterus in newborns.