A 25-year-old female, who has sustained multiple injures from a motor vehicle accident, has a blood pressure of 80/40 mm Hg and heart rate of 124 beats per minute
Which of the following volume expanders should the nurse anticipate being given in the acute resuscitation of the patient? 1. Normal saline solution
2. low titer O-positive blood
3. 25 percent human albumin solution
4. Lactated Ringer's solution
4
Rationale: Because the patient is unstable with low blood pressure and tachycardia, fluids and blood should be administered immediately to prevent hypovolemic shock that may be caused by severe traumatic hemorrhage. Lactated Ringer's is the intravenous fluid of choice and not normal saline. In addition, O-negative blood type is a universal donor and is the best choice for a female of childbearing age to prevent the development of anti-RH antibodies. Low titer O-positive blood would be the best choice if the patient were a male. Colloids such as albumin are not a good choice for acute fluids resuscitation of hemorrhagic shock.
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Community based (outpatient) facilities can provide which of the following services: Standard Text: Select all that apply
1. Adult day care 2. Client education 3. Respite care 4. Coronary care services 5. Custodial care
A professional female cyclist has been prescribed SMZ-TMP for chronic urethritis. She has informed the nurse that she has a cross-country race in 2 days. Which of the following would be an appropriate response by the nurse?
A) "I don't see any harm in participating in the race if you feel like it." B) "It would not be a good idea to be outside while taking this medication because of possible photosensitivity occurring." C) "You really don't need to participate in the race. It may aggravate the infection." D) "If you participate in the race you may be at risk for nerve damage."
The client has been diagnosed with an early stage of wide-angle glaucoma. The nurse is performing a wellness assessment during the client's initial interview
Which of the following statements by the client may be elicited during this portion of the health history? Standard Text: Select all that apply. 1. "My mom was diagnosed with glaucoma when she was 60 years old." 2. "I pay attention to the foods that I eat, because I want my body to stay well." 3. "I think I do a good job of managing stress with yoga every day and running three times a week." 4. "My husband and I have 3 couples that we would classify as our very good friends." 5. "Sometimes, my eyes feel very tired and sort of ache."
A community health nurse, visits an 81-year-old newly diagnosed insulin-dependent diabetic who lives alone. The nurse has visited the family three previous times and is visiting early in the morning to observe his client's insulin administration technique
The nurse finds the client depressed over his or her situation one morning. The nurse suggests that together they list positive points about his or her situation and discuss his or her feelings. This is an example of which of the following? A) Strengthening B) Data collection C) Goal-directed questioning D) Measuring family functioning