Medical-surgical nursing: Assessment and management of clinical problems (9 th ° ed., p. 1254-1255). St. Louis: Mosby. ° Awarded -1.0 points out of 3.0 possible points. ° 6.ID: 9476793886°A client informs the nurse that she has recently started taking the herbal supplement black cohosh for her menopausal symptoms. When reviewing the client’s medical record, what finding would warrant theneed for follow-up?Refer to chart. ° H i s t o r y a n d P h y s i c a l ° Laboratory Results ° M e di c at io n s ° R e n a l I n ° Thyroid Stimulating Hormone (TSH) 2.45 mIU/L ° Gl ipi zi de 5 m g
s u f f i c i e n c y or al on ce da ily ° H e a r t f a i l u r e ° B-type natriuretic peptide (BNP) 204 pg/ml ° Si m va st at in 4 0 m g on ce da ily A.TSH resultB.BNP resultC.Heart failureD.Glipizide prescription Correct°Rationale:°Black cohosh is an herbal product used to treat hot flashes, irritability, and palpitations. It potentiates insulin, oral hypoglycemic agents, and anti-hypertensive agents. Therefore, follow-up would be necessary if the client was
taking glipizide, a sulfonlyrea oral hypoglycemic agent. The TSH result is a normal finding. The BNP result would be expected with a known diagnosis of heart failure and additionally would not be affected by black cohosh. ° Test-Taking Strategy : Note the strategic words need for follow-up when considering what information provided in the chart is important. The options of heart failure and the BNP result are comparable or alike options, and therefore should be eliminated. Next, note that the TSH level is normal to eliminate this option. Review: interactions associated with black cohosh ° Level of Cognitive Ability : Synthesizing ° Client Needs : Safe and Effective Care Environment ° Integrated Process: Nursing Process: Analysis ° Content Area: Fundamental of Care: Safety ° Priority Concepts: Clinical Judgment, Safety ° HESI Concepts: ° Clinical Decision-Making/Clinical Judgment, Safety ° References: Hodgson, B., & Kizior, R. (2015). Saunders nursing drug handbook 2015 . (p. 1317 ). St. Louis: Saunders. ° Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9 th ° ed., p. 1285). St. Louis: Mosby. ° Awarded 1.0 points out of 1.0 possible points. °7.ID: 9476797805°A client is admitted to hospital for treatment of a respiratory infection. The client was treated with an intravenous (IV) course of ampicillin and is ready to be discharged home on oral antibiotics. What information present in the chart would warrant the nurse to provide further teaching ?
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