NUR 1212 Case Study - Adult Hephrolithiasis Questions And Answers Rated 100% Correct!!

In 20 minutes, the healthcare provider (HCP) visits Mr. Skene and prescribes one tablet of hydrocodone/acetaminophen 5 mg/300 mg by mouth to be given now as a preliminary pain medication. Which data in the client's medical record is important for the nurse to review before administering hydrocodone/acetaminophen ? (Select all that apply.) - ️️Allergies, Home medications, Liver enzymes, Vital signs Scottish heritage. When discussing his usual dietary intake with the nurse, Mr. Skene mentions that he does still enjoy many foods "from back home," such as smelt. Smelt is a fish that is very high in purine and can promote the formation of uric acid crystals in persons prone to developing them. Which response by the nurse is most helpful to the client? - ️️How much and how often do you eat smelt? The nurse takes Mr. Skene to the triage area and performs a focused assessment of his nontraumatic, mid-lower flank pain. If a client has symptoms of tenderness at the costovertebral angle (CVA), what should be the nurse's priority? - ️️Assess for bladder distention. The triage nurse continues to assess Mr. Skene's pain. Which elements should be included in the pain assessment? (Select all that apply.) - ️️Quality, severity, timing In 5 minutes, the triage nurse takes Mr. and Mrs. Skene to a treatment room, where the ED nurse interviews Mr. Skene about his health history. Which reported chronic condition in Mr. Skene's health history is most significant to his acute condition and the reason for this visit? - ️️Gouty arthritis. Mr. Skene's medical record has no allergies listed. Which action is the best intervention for the nurse to perform next? - ️️Ask the client if he has any food or drug allergies. Mr. Skene reports to the nurse that he has a codeine allergy. When he had a cold last winter, he was prescribed cough syrup with codeine and it gave him a rash all over his body. The HCP advised his wife to give him diphenhydramine 50 mg by mouth and it got better in a couple of days. He states that he stopped taking the cough syrup and he eventually got better. The nurse records the allergy report in Mr. Skene's medical record and prepares to speak with the HCP. Which information is important for the nurse to include in the conversation with the HCP? (Select all that apply.) - ️️The client has no allergies listed in his medical recordHydrocodone/acetaminophen is prescribed for pain. The client reports that cough syrup with codeine gave him a rash. The nurse requests a prescription for fentanyl 50 mcg intravenous now. The HCP cancels the hydrocodone/acetaminophen prescription and prescribes fentanyl 50 mcg intravenously one time now with a 500 mL normal saline bolus. Prescriptions for abdominal radiography and computed tomography (CT) scan with contrast are also added. The nurse obtains a vial of fentanyl for intravenous administration from the medication cabinet. - ️️1 mL (2 mL/100 mcg x 50 mcg = 1 mL) Mr. Skene quietly paces in the ED waiting area with his hands on his hips and rubbing his mid-lower left side. He has a flat facial expression. Which factor is most important for the nurse to consider when interpreting this client's pain behavior? - ️️Client's cultural identity. The nurse inserts a peripheral intravenous catheter, gives the IV fentanyl and the saline bolus, and enters the radiology prescriptions into the computerized order entry system. Which actions should the nurse take next? (Select all that apply.) - ️️Determine when the last dose of glucophage was taken Have the client rate his pain on a 10-point scale. Question the client about any shell fish allergies. Mr. Skene returns from the radiology department and the HCP tells him that several renal calculi were found on the CT scan. Which discharge instructions should the nurse anticipate giving Mr. Skene? (Select all that apply.) - ️️How to use a urine strainer. Medication instructions. Increase fluid intake. Follow up with a nephrologist. The nurse is teaching Mr. and Ms. Skene about his prescription for tamsulosin. Which rationale explains why Mr. Skene is being prescribed this medication? - ️️Dilates the ureter. In 2 days, Mr. Skene finds a stone in his urine strainer and takes it to the nephrologist's clinic. The HCP sends the sample to the laboratory and the result reveals that the calculus consists of sodium uric acid precipitant. The ED nurse notes that Mr. Skene reports having chronic, intermittent episodes of gout when documenting his health history. What is the pathophysiology of gout? - ️️Formulation of uric acid crystals within the joints.How are gout and nephrolithiasis related in this scenario? - ️️Both conditions are caused by uric acid crystallization How are gout and nephrolithiasis related in this scenario? (QUESTION WAS DUPLICATED IN THE CASE STUDY) - ️️Both conditions are caused by uric acid crystallization The nurse teaches Mr. Skene about dietary practices that can reduce his incidence of gout and sodium uric acid nephrolithiasis. What is most important to establish before initiating the teaching session? - ️️Who plans and cooks the meals in the Skene household. What dietary substance should the nurse instruct the client to reduce or eliminate as much as possible? - ️️Purine. What other issue is most important for the nurse to consider when teaching Mr. Skene about making dietary adjustments to promote his health? - ️️Cultural influences.