Answer to Question 1
D
Feedback:
The potential for nephrotoxicity and ototoxicity with amikacin is very high, so the drug is used only as long as absolutely necessary and should not be administered for longer than 7 to 10 days because of its potentially toxic adverse effects, which include renal damage, bone marrow depression, and gastrointestinal (GI) complications. The nurse cannot stop administering the drug after 7 days if the doctor orders it to be given longer but the nurse could question the order and promote change to another antibiotic if necessary. Monitoring renal function is the priority action when this drug is administered and the provider should be notified if signs of renal failure occur. Liver function is not usually impacted by this drug, although a patient with preexisting liver alterations may require a change in dosage to prevent toxicity. There is no indication of a need to contact the health care provider.
Answer to Question 2
A
Feedback:
The treatment of choice for DIC is heparin, an anticoagulant. It prevents the clotting phase from being completed, thus inhibiting the breakdown of fibrinogen. It may also help avoid hemorrhage by preventing the body from depleting its entire store of coagulation factors. None of the other medications listed in this question are indicated for treatment of DIC and may, in fact, make the condition worse.
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Health care - patient-centered
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Schematic depiction of the action of tryptophan synthase in one functional unit