The nurse is caring for a patient who has aortic stenosis. During data collection, which of these manifestations should indicate to the nurse that the patient is experiencing myocardial oxygen deficiency?
a. Angina
b. Sacral edema
c. Jugular vein distention
d. Pericardial friction rub
ANS: A
Angina results if cardiac oxygen needs are not met. B. C. D. A lack of myocardial oxygen does not cause sacral edema, jugular vein distention, or pericardial friction rub.
You might also like to view...
What is generally considered the most valid means of developing the knowledge base of nursing?
1. Scientific research. 2. Evidence-based practice. 3. Qualitative research. 4. Outcomes research.
The local health department nurse manager has developed and implemented a disaster readiness plan as part of a community service. Community services:
a. Care for the specific needs of individual families in the community. b. Focus on the treatment of communi-ty-wide problems rather than on individual health problems. c. Do not include services provided by pub-lic health departments. d. Provide personal health follow-up for all acute care hospitalizations.
After dressing a sucking chest wound, the nurse notes that the client is developing severe dyspnea, tachypnea, cyanosis, tachycardia, and asymmetrical chest movements. The nurse would
a. check the chest dressing for any air leakage. b. insert an 18-gauge needle into the pleural space. c. notify the physician. d. remove the chest dressing.
The nurse notes that a newborn has a meconium stool. The nurse describes in intershift report that the stool had which of the following characteristics?
1. white or clay-colored 2. black and tarry 3. brown-colored 4. clear with mucus shreds