A 14-year-old boy is brought to the clinic by his mother. The ...

[craiczarry]

A 14-year-old boy is brought to the clinic by his mother. The patient has a note from his basketball coach explaining that a member of the team has been diagnosed with hepatitis A infection.
 
  The nurse notes that the patient has an extensive list of allergies. What is the nurse's priority action when administering the immune globulin? A) Perform a hepatitis A antibody check.
  B) Monitor the patient carefully and have emergency equipment ready if needed.
  C) Apply ice to the injection site to slow the absorption of the serum.
  D) Give the patient aspirin and a corticosteroid before the injection to modulate reaction.

Question 2

The patient with hypothyroidism takes levothyroxine daily and has triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) levels drawn in the laboratory to check appropriateness of prescribed dosage.
 
  What results would the nurse analyze as indicating the need for a higher dosage of medication? A) Elevated TSH, elevated T3, and reduced T4 levels
  B) Reduced TSH, elevated T3 and T4 levels
  C) Elevated TSH, reduced T3 and T4 levels
  D) Reduced TSH, T3, and T4 levels

[amandanbreshears]

Answer to Question 1

B
Feedback:
If a patient has known allergies, it is important to monitor the patient carefully and have emergency equipment ready if needed after injection of proteins such as immune globulin. Severe allergic reactions, including anaphylaxis, could occur. Ice would slow absorption of the immune globulin, delaying the reaction and delivery of the immune globulin to the bloodstream where it can act on the hepatitis A virus. If a person had hepatitis A antibodies, the immune globulin would not be needed. The delay in getting that information could be problematic if the patient had been exposed to hepatitis A. Aspirin should be avoided in children due to risk of Reye's syndrome. Corticosteroids can reduce immune response and so would be contraindicated.

Answer to Question 2

C
Feedback:
TSH levels would be elevated to stimulate increased thyroid hormone secretion whereas T4 and T3 will be low, which indicates the need for a higher dosage of medication. If TSH level is low, it would indicate a reduction in dosage would be needed, particularly if T3 and T4 levels are elevated.