While recovering from surgery to repair an aneurysm the nurse is concerned the patient is experiencing vasospasm
What did the nurse assess in the patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Increased lethargy
2. Elevated body temperature
3. Nuchal rigidity
4. Dysphagia
5. Ventricular dysrhythmia
1,2,3,4
Rationale 1: A change in mental status such as lethargy is a symptom associated with vasospasm.
Rationale 2: Elevated body temperature is a symptom associated with vasospasm.
Rationale 3: Neck stiffness is a symptom associated with vasospasm.
Rationale 4: Dysphagia is a symptom associated with vasospasm.
Rationale 5: Ventricular dysrhythmia is not a symptom associated with vasospasm.
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