The nurse assessing a patient's wound notes bright red drainage. How will the nurse most accurately document this finding?
a. Serous drainage
b. Purulent drainage
c. Sanguineous drainage
d. Serosanguineous drainage
ANS: C
Sanguineous drainage is bright red and indicates active bleeding. Serous drainage has the appearance of clear, watery plasma. Purulent drainage has the appearance of thick, yellow, green, tan, or brown drainage. Serosanguineous drainage is pale, red, and watery and is a mixture of serous and sanguineous drainage.
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The perinatal nurse describes risk factors for placenta previa to the student nurse. Which of the following risk factors does the nurse include? (Select all that apply.)
A. Cocaine use B. Previous cesarean birth C. Previous use of medroxyprogesterone (Depo-Provera) D. Tobacco use E. Young maternal age
Following the identification of low levels of T3 and T4 coupled with the presence of a goiter, a 28-year-old female has been diagnosed with Hashimoto thyroiditis In light of this diagnosis, which of the following assessment results would constitute an unexpected finding?
A) The presence of myxedema in the woman's face and extremities B) Recent weight gain despite a loss of appetite and chronic fatigue C) Coarse, dry skin and hair with decreased sweat production D) Increased white cell count and audible crackles on chest auscultation
During an assessment, the nurse learns that a client seeking emergency treatment for a headache and nausea works in a mill without air conditioning
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If the client's white blood cell count is 25,000/mm3 on her second postpartum day, the nurse should:
a. Tell the physician immediately. b. Have the laboratory draw blood for reanalysis. c. Recognize that this is an acceptable range at this point postpartum. d. Begin antibiotic therapy immediately.