The metabolic acidosis of shock is caused by which of these mechanisms?
a. Decreased anaerobic metabolism
b. Release of cortisol and glucagons
c. Excessive aerobic metabolism
d. Excessive anaerobic metabolism
ANS: D
Anaerobic metabolism results in the production of lactic acid as an unwanted by-product. Unless the lactic acid can be circulated to the liver and thus removed from the bloodstream, the blood will become increasingly acidic.
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A client receiving chemotherapy has a white blood cell count of 1000/mm3. What actions by the nurse are most appropriate? (Select all that apply.)
a. Assess all mucous membranes every 4 to 8 hours. b. Do not allow the client to eat meat or poultry. c. Listen to lung sounds and monitor for cough. d. Monitor the venous access device appearance with vital signs. e. Take and record vital signs every 4 to 8 hours.
An 81-year-old patient of a subacute geriatric medical unit has become incontinent of stool over the past several days. This development has coincided with a decline in the patient's cognition as a result of severe Alzheimer's disease
In light of the patient's fecal incontinence, what nursing diagnosis should the nurse prioritize when planning this patient's care? A) Altered role performance related to fecal incontinence B) Altered nutrition, less than body requirements related to fecal incontinence C) Situational low self-esteem related to fecal incontinence D) Impaired skin integrity related to fecal incontinence
The patient asks the nurse, "I am having a debridement of my leg tomorrow. What does this mean?" What is the most appropriate response by the nurse?
a. You will be evaluated to see how the wound will respond to medications. b. You will be fitted for a dressing to wear permanently on your wound. c. You will need to ask the doctor what that means, I'm not really sure. d. You will have the dead, or necrotic, tissue removed from your leg. This procedure will help the wound heal.
Patients with fractures, back surgeries, or joint replacements should be instructed to
A) Use a pull sheet with movement B) Log roll to the side of the bed C) Use the overhead trapeze D) Pull up with the headboard