Question

The nurse should question giving oral medications in which of these situations? (Select all that apply)

Answers:

A Recent episode of bloody emesis

B Client returned from a bronchoscopy which required local anesthesia of the gag reflex

C Client is schedule for a non-invasive cardiac ultrasound within the hour

D Client has a history of severe epigastric pain that suddenly disappeared an hour ago

E Client has just been diagnosed with acute pancreatitis

F Client has an elevated INR (prolonged clotting time)

Answer 1

A. Recent episode of bloody emesis

Rationale: Blood in vomit indicates upper Gastro intestinal track bleeding which requires Nil per Oral -NPO or Nil by mouth -NMB to analysis and exam the up GI tract.

B. Client returned from a bronchoscopy which required local anaesthesia of the gag reflex

Rationale: bronchoscopy procedure requires local anaesthesia in Spray form to make the upper respiratory tract to desensitise in or order to avoid pain and discomfort during insertion of Bronchoscope.

In the recovery time of post bronchoscopy need keep the client in Nil per Oral -NPO or Nil by mouth –NMB till the Gag reflux to avoid Aspiration.

E Client has just been diagnosed with acute pancreatitis

Rationale: Acute pancreatitis requires NPO to avoid secretion of pancreatic enzymes and maintain good hydration via intravenous fluids.

Pain can be aggravated by ingestion of medications, should be questioned PCP before administering the oral medication.

D. Client has a history of severe epigastric pain that suddenly disappeared an hour ago

This seems like symptoms of gastritis/gastric or duodenal ulcer, certain medication should not be given orally such as Aspirin, Corticosteroids and non steroidal anti inflammatory drugs.

Not the Answers:

C. Client is schedule for a non-invasive cardiac ultrasound within the hour

Rationale: Can give oral medication since this procedure does not require NPO.

F Client has an elevated INR (prolonged clotting time)