Author Question: Treatment for a client with bleeding esophageal varices has been unsuccessful and the physician ... (Read 45 times)

dalyningkenk · **on:** Jul 22, 2018

Treatment for a client with bleeding esophageal varices has been unsuccessful and the physician decides to insert a Sengstaken-Blakemore tube. The nurse brings which of the following items to the bedside so that it is available at all times?

1. An obturator
2. A Kelly clamp
3. An irrigation set
4. A pair of scissors

Question 2

The client with acquired immunodeficiency syndrome (AIDS) and Pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The nurse caring for the client monitors the client most closely for signs of:

1. Nausea
2. Fatigue
3. Infection
4. CD4+ cell count

amandalm · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

4

Rationale: When the client has a Sengstaken-Blakemore tube inserted, a pair of scissors must be kept at the client's bedside at all times. The client must be observed for sudden respiratory dis-tress, which occurs if the gastric balloon ruptures, moving the entire tube upward. If this occurs, all balloon lumens are cut and the tube is removed. An obturator and Kelly clamp would be kept at the bedside of a client with a tracheostomy. An irrigation set may be kept at the bedside but is not the priority item.

Answer to Question 2

3

Rationale: Adverse effects of pentamidine (Pentam 300) include leukopenia, thrombocytopenia, and anemia. The client should be monitored routinely for signs and symptoms of infection. The client also should have ongoing monitoring of a number of parameters because of the nature and side effects of the medication, including complete blood cell count, liver function, blood glucose, blood urea nitrogen, and serum creatinine, calcium, and magnesium levels.