How can central venous access devices (CVADs) be of value in a patient receiving chemotherapy who has stomatitis and severe diarrhea?

Correct Answer: D

Rationale: Central venous access devices (CVADs) can be of value in a patient receiving chemotherapy who has stomatitis and severe diarrhea by allowing concentrated hyperalimentation fluid to be administered through the CVAD. Stomatitis and severe diarrhea can significantly affect oral intake and absorption of nutrients, leading to malnutrition and dehydration. By administering concentrated hyperalimentation fluid through a CVAD, the patient can receive the necessary nutrition and hydration directly into the bloodstream, bypassing the gastrointestinal tract. This can help maintain the patient's nutritional status and manage dehydration effectively during chemotherapy treatment.

Correct Answer: A

Rationale: Lyme disease (bulls-eye rash) in a 6-year-old is treated with doxycycline, but tooth discoloration in children under 8-contraindicates it. Tetracyclines bind calcium, staining developing teeth. Anemia , nephrotoxicity , and ototoxicity are rare. Myalgias (E) aren't relevant. Given his age, amoxicillin is preferred to avoid this permanent cosmetic effect, despite doxycycline's efficacy against Borrelia burgdorferi.

Correct Answer: D

Rationale: Antilipemic therapy is used to lower cholesterol levels in the blood. This type of therapy often places a strain on the liver as it metabolizes and processes the cholesterol-lowering medications. Therefore, patients receiving antilipemic therapy are at an increased risk of developing liver dysfunction. The nurse should monitor the patient closely for signs and symptoms of liver dysfunction, such as jaundice, abdominal pain, nausea, vomiting, and changes in liver function tests. Early detection and intervention can help prevent serious complications associated with liver dysfunction.

Correct Answer: D

Rationale: Serotonin reuptake blockade increases synaptic levels. Buspirone, a 5-HT1A agonist, treats anxiety without reuptake effects. Pizotifen, a serotonin antagonist, prevents migraines. Granisetron, a 5-HT3 antagonist, controls nausea. Paroxetine, an SSRI, potently inhibits serotonin reuptake, elevating mood in depression. Sumatriptan activates 5-HT1 receptors. Paroxetine's mechanism is central to its antidepressant efficacy, distinguishing it from receptor modulators.

Correct Answer: C

Rationale: The fundamental action of drugs that can be used as a substitute for what is lacking in the body falls under the category of Replacement. In medical terms, replacement therapy is a type of treatment that involves replacing a hormone or other important substance that is deficient or lacking in the body. For example, individuals with hypothyroidism are often prescribed levothyroxine as a replacement therapy to make up for the thyroid hormone deficiency in their body. Similarly, insulin is used to replace the deficient insulin in individuals with diabetes. Therefore, when drugs are administered to compensate for a deficiency or lack of a specific substance in the body, they are categorized under the fundamental action of Replacement.

Correct Answer: D

Rationale: Lithium is commonly used to treat bipolar disorder, where it is effective in reducing the frequency and severity of acute manic episodes. By stabilizing mood, lithium helps in preventing or decreasing the occurrence of manic episodes, which are characterized by elevated, irritable moods, increased energy, and impulsivity. However, it is important to note that lithium does not typically have direct effects on reducing the risk of myocardial infarction, GI ulcers, or respiratory distress.

Correct Answer: C

Rationale: Alendronate's rare eye effects-vision changes, photophobia-signal inflammation, needing report, per safety. Ringing ears, hot skin, or spasms aren't linked-GI/esophageal issues dominate. Eye symptoms prompt action, per teaching.

Correct Answer: C

Rationale: The patient is experiencing gastrointestinal upset from taking aspirin. Enteric-coated aspirin would be a suitable alternative in this case because the special coating on the aspirin helps protect the stomach lining and reduces the risk of gastrointestinal irritation. Switching to an enteric-coated aspirin can still provide the antiplatelet benefits needed for secondary prevention of myocardial infarction while minimizing the gastrointestinal side effects. It is important to address the patient's symptoms while ensuring that they continue to receive appropriate treatment for their medical condition.

Correct Answer: A

Rationale: Amiodarone, labetalol, and carvedilol are not indicated for pediatric use and do not have established pediatric dosages. Phentolamine and prazosin have established pediatric dosages and would not need to be questioned. The nurse should always verify the appropriateness of medications for pediatric patients, as their pharmacokinetics and pharmacodynamics differ from adults.