When a client is brought from the surgical suite to the postanesthesia care unit, the nurse will conduct a rapid head-to-toe visual assessment. Which of the following statuses will be assessed during the initial assessment? (Select all that apply.)
1. Surgical site
2. Vital signs
3. Respiratory stability
4. Circulatory stability
5. Range of motion of lower extremities
6. Bowel sounds
1, 2, 3, 4
When a client is admitted to the postanesthesia care unit, the initial head-to-toe assessment includes surgical site, vital signs, respiratory stability, and circulatory stability. Range of motion of the lower extremities and bowel sounds are not a part of the initial head-to-toe assessment.
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The nurse recognizes that pain can be managed what percentage of the time?
a. 50% to 55% b. 60% to 65% c. 70% to 80% d. 95% to 97%
Mrs. L. Billings is a 77-year-old Caucasian female who has a history of breast cancer. She has been in remission for 6 years
As her primary care provider, you are seeing her for follow-up of her recent complaint of intermittent abdominal pain of a 3-month duration and some general malaise. Given the brief history above, what will you direct your assessment at during physical examination? A. Examination of her thyroid to rule out thyroid nodules that may contribute to her feeling fatigued. B. Auscultation of her abdomen for abnormal bowel sounds to rule out peritonitis. C. Thorough abdominal and gynecological exam to rule out masses and identify any tenderness. D. A rectal examination to rule out colon cancer as a secondary site for breast cancer.
The physician orders vancomycin (Vancocin) 500 mg q.6h. Directions on the label instruct 500 mg vial to be diluted with 10 mL of sterile water and then further diluted with 100 mL of D5W
How many mL of fluid will there be in the VCC when medication is ready to infuse? 1. 100 mL 2. 10 mL 3. 110 mL 4. 115 mL
A patient is prescribed furosemide (Lasix) for hypertension and heart failure. Which statement should the nurse use to explain the purpose of this medication to the patient?
a. "The medication vasodilates the arterioles so the heart doesn't have to pump as often." b. "Furosemide increases cardiac output so workload is decreased and the heart pumps more effectively." c. "By removing excess water, blood pressure and then cardiac workload are lowered so the heart doesn't work so hard." d. "Furosemide increases the blood flow to the kidneys so the normal renin-angiotensin cycle is optimized and blood pressure is lowered."