The nurse is preparing to assess a patient admitted for treatment of bilateral pleural effusions. On what should the nurse focus when assessing this patient?
Select all that apply.
1. Urine output
2. Cardiac rate and rhythm
3. Joint function and mobility
4. Muscle tone and movement
5. Peripheral pulses and edema
Correct Answer: 1, 2, 3, 5
Excess pleural fluid may be either transudate, formed when capillary pressure is high or plasma proteins are low, or exudate, the result of increased capillary permeability. Heart failure is the most common precipitating factor in transudate formation; it also may accompany renal failure and an inflammatory process such a systemic inflammation associated with rheumatoid arthritis. The nurse should focus on the patient's urine output, cardiac status, peripheral pulses, edema, and joint mobility and function. Muscle tone is not affected by pleural effusion.
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The nurse is monitoring an IV line for a client who is receiving IV antibiotics. Which of the following is a recommended guideline when caring for the client receiving IV therapy?
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