The client has been diagnosed with a severe anxiety disorder and has been admitted to the psychiatric unit for treatment. The nurse suspects that the client may experience which of the following on admission?
1. Vomiting and diarrhea
2. Memory loss
3. Hypoventilation
4. Respiratory alkalosis
4. Respiratory alkalosis
Rationale: Anxiety disorders increase the risk for the acid-base imbalance respiratory alkalosis, due to hyperventilation that accompanies anxiety. The client with anxiety does not necessarily have vomiting, diarrhea, or memory loss as risk factors. Anxiety will lead to hyperventilation, not hypoventilation.
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The nurse identifies which patient as having the highest risk of erectile dysfunction?
A) Patient who is obese and has poorly controlled type 2 diabetes B) Patient who is 80 years old and has a colostomy following colon cancer 7 years prior C) Patient who is 71 years old and was recently diagnosed with Parkinson disease D) Patient who has a diagnosis of lung cancer following a work history that included asbestos exposure
An RN who practices in a community clinic recognizes the need for a standardized classification and documentation system. Which of the following systems of nursing care classification and documentation would best fit the RN's needs?
A) NANDA International (NANDA-I) B) Nursing Outcomes Classification (NOC) C) The Omaha System D) Patient Care Data Set (PCDS)
A nurse sees another nurse changing an intravenous (IV) solution because the wrong solution is infusing into the client. The nurse who changed the IV solution does not report the error. What should the nurse who observed the error do first?
A. Call the client's health care provider B. Document the error in the client's chart C. Report the nurse who changed the IV solution D. Ask the nurse whether she intends to report the error
Nursing interventions to limit the complications of suctioning include
a. inserting the suction catheter no more than 5 inches. b. premedicating the patient with atropine. c. hyperoxygenating the patient with 100% oxygen. d. increasing the suction to 150 mm Hg.