A patient overdosed on aspirin several hours ago and is brought ...

[CQXA]

A patient overdosed on aspirin several hours ago and is brought to the emergency department. The nurse assists with supportive care and then asks the provider about an order for which drug?
 
  a. Activated charcoal
  b. Ammonium chloride
  c. Fomepizole Antizol
  d. Sodium bicarbonate

Question 2

A patient is taking cyclosporine Sandimmune and prednisone to prevent organ rejection after right renal transplantation. The patient is febrile and complains of right-sided flank pain.
 
  The nurse reviews the patient's chart and finds that the patient's BUN and serum creatinine are ele-vated. The cyclosporine trough is 150 ng/mL. What will the nurse do? a. Be concerned that the left kidney is fail-ing.
  b. Expect the provider to order intravenous methylprednisolone.
  c. Request an order for a urine culture.
  d. Suspect nephrotoxicity secondary to an elevated cyclosporine level.

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Answer to Question 1

D
Sodium bicarbonate is indicated for a patient who has toxic levels of aspirin. It acts by creating an alkaline urine, which reduces passive reabsorption of acids such as aspirin and accelerates its excretion. Activated charcoal is not effective after hours have passed. Ammonium chloride makes the urine more acidic. Fomepizole is used for ethylene glycol ingestion.

Answer to Question 2

B
The patient is showing signs of acute organ rejection, which include pain at the graft site, fever, and elevated BUN and creatinine; therefore, intravenous methylprednisolone is indicated. Be-cause the patient is having pain on the right side, along with fever and elevated renal function test results, there is no reason to suspect that the left kidney is failing or that an infection is present. The cyclosporine level is within normal limits.