Author Question: A 187-pound patient presents to the emergency department after a motor vehicle accident. The ... (Read 47 times)

Chelseaamend · **on:** Jul 23, 2018

A 187-pound patient presents to the emergency department after a motor vehicle accident.

The patient is confused, has a superficial cut on the head, a bruised abdomen, and a compound fracture of the right femur. The patient's vital signs are: P122/minute, R32/minute, BP100/51, and T99.0 F. Based on these findings, the nurse should prepare to administer which of the following intravenous solutions?
a. 0.9 NaCl
b. D5W
c. 3 NaCl
d. D5 NS

Question 2

A patient has been taking digoxin (Lanoxin), 0.25 mg, and furosemide (Lasix), 40 mg, daily. Upon routine assessment by a nurse, the patient states, I see yellow halos around the lights.

The nurse should perform which of the following interactions based on this assessment?
a. Assess the patient for other symptoms of digitalis toxicity.
b. Withhold the next dose of furosemide.
c. Continue to monitor the patient for heart failure.
d. Document the findings and reassess in 1 hour.

Moriaki · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
Administration of an isotonic solution would be the correct action because of the expected loss in blood volume after the patient's accident and subsequent injuries.
D5W would be indicated for hypoglycemia.
3 NaCl would be indicated for hyponatremia.
D5 NS would also be indicated if the patient had hypernatremia.

Answer to Question 2

ANS: A
Yellow halos around lights are indicative of digoxin toxicity. The use of furosemide increases the risk of hypokalemia, which in turn potentiates digoxin toxicity. The patient should also be assessed for headache, nausea, and vomiting, and blood should be drawn for measurement of the serum digoxin level.
The nurse should not withhold the dose of furosemide until further assessment is done, including measurement of a serum digoxin level.
No evidence indicates that the patient is in heart failure that is worsening.
Documentation of findings is secondary to further assessment and prevention of digoxin toxicity.