Author Question: Clinical students are receiving instruction on Francisella tularensis (tularemia). Which statements ... (Read 78 times)

penza

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Clinical students are receiving instruction on Francisella tularensis (tularemia). Which statements about tularemia demonstrate understanding by the students? (Select all that apply.)
 
  a. It begins with flulike symptoms.
  b. It can develop into pneumonia or pleuritis, or both.
  c. Tularemia can be treated with an antitoxin.
  d. The treatment of choice for tularemia is intravenous streptomycin.
  e. Tularemia is transmitted from person to person.

Question 2

An individual brought to the emergency department (ED) and is suspected of having taken an overdose of pilocarpine (Pilocar) 3 hours ago.
 
  Upon assessment, that nurse notes profuse salivation, lacrimation, bronchospasm, diarrhea, a blood pressure of 82/40, and a heart rate of 51. The nurse should prepare to administer
  a. epinephrine (Adrenalin).
  b. atropine (Sal-Tropine).
  c. activated charcoal.
  d. syrup of ipecac.



chloejackso

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Answer to Question 1

ANS: A, B
Individuals with symptoms of tularemia have acute, flulike symptoms that may develop into pneumonia and pleuritis.
Antitoxin is available only for botulism.
The treatment of choice for tularemia is intramuscular (IM) streptomycin, not IV streptomycin.
Tularemia cannot be transmitted from person to person. The infection is transmitted by a vector and is acquired through the skin, mucous membranes, gastrointestinal tract, or lungs.

Answer to Question 2

ANS: B
The patient is showing symptoms of systemic absorption of pilocarpine. Systemic toxicity should be reversed with a muscarinic antagonist, such as atropine.
Epinephrine may be helpful for increasing the heart rate. However, it does not contain anticholinergic properties and would not be the best choice.
Activated charcoal is the preferred method for removing ingested poisons from the gastrointestinal tract.
Syrup of ipecac is not indicated, because it induces vomiting but only removes 30 of the ingested poison even when given early.



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