The nurse is caring for a 60-year-old male patient with pulmonary arterial hypertension. The patient, who has been receiving epoprostenol (Flolan), begins to complain of malaise
Upon as-sessment, the vital signs reveal: temperature 104.2° F, pulse 112, respiration 24, and blood pres-sure 98/44 . The nurse suspects sepsis. What intervention would help confirm the nurse's suspi-cions?
a. Send a urinalysis (UA).
b. Obtain a white blood cell (WBC) count.
c. Culture the central venous catheter tip.
d. Withdraw the drug to see whether the sepsis symptoms abate.
C
Epoprostenol is administered only by intravenous (IV) infusion through a central line. This pa-tient is at risk of catheter-related sepsis, of he is showing signs and symptoms.
Sepsis cannot be confirmed with a urinalysis or a WBC count; those would only indicate that an infection is present.
Withdrawal of the medication is not indicated and would not confirm the nurse's suspicions.
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A 70-year-old patient with a history of hypertension has a blood pressure of 180/100 mm Hg and a heart rate of 90 beats per minute. The nurse hears an extra heart sound at the apex immediately before the S1
The sound is heard only with the bell of the stethoscope while the patient is in the left lateral position. With these findings and the patient's history, the nurse knows that this extra heart sound is most likely a(n): a. Split S1. b. Atrial gallop. c. Diastolic murmur. d. Summation sound.
A client has experienced a transient ischemic attack (TIA) and presents with carotid bruits. Which is the priority action to be taken by the nurse, following a bilateral carotid endarterectomy?
A) Encourage deep breathing and coughing. B) Observe for facial swelling. C) Anticipate need for endotracheal intubation. D) Resume antilipemic drugs.
Which client outcome provides reassurance that the therapeutic regimen managing the client with schizophrenia is appropriate? Select all that apply
A) The client can discuss the mental health condition. B) The client understands the medical management. C) The client lives alone and leaves his home infrequently. D) The client reports decrease in hallucinations and delusions. E) The client has been able to become an upstanding member of society. F) The client relies on family members to help with daily activities.
A nurse is working in a health care organization that has achieved Magnet status. Which components are indicators of this status? (Select all that apply.)
a. Empirical quality results b. Structural empowerment c. Transformational leadership d. Exemplary professional practice e. Willingness to recommend the agency