Which patient does the nurse most closely monitor for an ...

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Which patient does the nurse most closely monitor for an unintended synergistic effect?
 
  a. The 4 year old who has mistakenly taken a half bottle of vitamins
  b. The 35 year old who has ingested meth mixed with several household chemicals
  c. The 50 year old who is prescribed a second blood pressure medication
  d. The 72 year old who is seeing four different specialists

Question 2

A nurse is caring for a patient who is receiving pain medication through a saline lock. After obtaining a good blood return when the nurse is flushing the patient's peripheral IV, the patient reports pain.
 
  Upon assessment, the nurse notices a red streak that is warm and tender to the touch. What is the nurse's initial action?
  a. Do not administer the pain medication.
  b. Administer the pain medication slowly.
  c. Apply a warm compress to the site.
  d. Apply a cool compress to the site.

[maya.nigrin17@yahoo.com]

Answer to Question 1

ANS: D
The 72 year old seeing four different providers is likely to experience polypharmacy. Polypharmacy places the patient at risk for unintended mixing of medications that potentiate each other. When two medications have a synergistic effect, their combined effect is greater than the effect of the medications when given separately. The child taking too much of a medication by mistake could experience overdose or toxicity. The 50 year old is prescribed two different blood pressure medications for their synergistic effect, but this is a desired, intended event. A patient taking meth and mixing chemicals can be toxic.

Answer to Question 2

ANS: A
The patient has phlebitis; the initial nursing action is do not administer the medication. The medication should not be given slowly. A cool or warm compress may be used later depending upon protocol, but it is not the first action.

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