The nurse is orienting a graduate nurse to a medical-surgical ...

[PhilipSeeMore]

The nurse is orienting a graduate nurse to a medical-surgical unit. The nurses receive an order to administer a whole bowel irrigation. The graduate nurse would be correct to
 
  a. have the patient drink a solution of polyethylene glycol.
  b. administer a high-dose rectal laxative.
  c. insert an oral-gastric tube so that the patient does not have to drink the solution.
  d. administer enemas until clear.

Question 2

The nurse works on a medical-surgical unit and admits a new patient from the ED with many orders, including one to administer an IV solution of sodium bicarbonate.
 
  The nurse suspects that the patient has ingested toxic amounts of _________ and understands that the sodium bicarbonate will ____________.
  a. amphetamines; neutralize the acids to prevent further toxicity
  b. acetaminophen (Tylenol); reduce hepatotoxicity
  c. aspirin; create an alkaline urine to accelerate excretion
  d. opioids; act as an antagonists to receptor sites

[bob]

Answer to Question 1

ANS: A
Whole bowel irrigation is done with a solution of polyethylene glycol, which contains balanced electrolytes. The patient can drink the solution, or it can be delivered through a nasogastric tube so that it passes through the small and large intestines.
Administration of a high-dose rectal laxative will not help evacuate the entire intestinal tract.
An oral-gastric tube is not appropriate because it will be extremely uncomfortable for an alert patient beyond the initial insertion. If the patient cannot tolerate drinking the solution, a nasogastric tube may be inserted to administer the solution. Discomfort from the tube should be limited to the insertion process.
Administering enemas until they run clear is not useful for evacuating the entire intestinal tract.

Answer to Question 2

ANS: C
Sodium bicarbonate is indicated for a patient who has toxic levels of aspirin. It acts by creating alkaline urine, which reduces passive reabsorption of acids such as aspirin and accelerates its excretion.
Bicarbonate is not indicated for amphetamine overdose.
Acetylcysteine (Mucomyst), not bicarbonate, is indicated for acetaminophen overdose.
Naloxone (Narcan), not bicarbonate, is indicated for opioid overdose.

[PhilipSeeMore]

Gracias!

[kusterl]

Excellent