Which nursing intervention would take priority following ...

[Davideckstein7]

Which nursing intervention would take priority following administration of a new medication?
 
  1. Monitoring lab values
  2. Monitoring the patient's respiratory status
  3. Prescribing additional medications if side effects occur
  4. Measuring patient weight

Question 2

A trauma patient in the emergency department has a low hemoglobin and hematocrit, and has an order to receive normal saline IV solution. Which nursing diagnosis would be most appropriate regarding the need for administering the IV solution?
 
  1. Activity intolerance
  2. Fluid volume deficit
  3. Decreased cardiac output
  4. Risk for Infection

[kilada]

Answer to Question 1

Correct Answer: 2
Rationale: Any time a new medication is provided to the patient, it is important to monitor for an allergic reaction. Anaphylaxis, a life-threatening allergic reaction, can impair breathing. Monitoring lab values and measuring weight might be appropriate nursing interventions with some medications, but would not be the priority. Nurses do not prescribe medications.

Answer to Question 2

Correct Answer: 2
Rationale: The drop in hemoglobin and hematocrit signify blood loss following trauma. Fluid volume deficit would be the best nursing diagnosis. The patient's activity might be altered, and he might be at risk for infection following the trauma, but these do not relate to administering the IV normal saline. It is more likely that the patient has a drop in hemoglobin and hematocrit as a result of the trauma than a cardiac problem.