The patient is being admitted with GI bleeding. Blood work includes serial hemoglobin and hematocrit levels. The nurse understands that:
a. the hematocrit is a direct reflection of quick blood loss.
b. as extravascular fluid enters the vascular space the hematocrit increases.
c. the hematocrit value does not change substantially during the first few hours.
d. the administration of intravenous fluids has no effect on hematocrit levels.
C
The hematocrit (Hct) value does not change substantially during the first few hours after an acute bleeding episode. During this time, the severity of the bleeding must not be underestimated. Only when extravascular fluid enters the vascular space to restore volume does the Hct value decrease. This effect is further complicated by fluids and blood products that are administered during the resuscitation period.
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A client with Crohn's disease is recovering from a fourth bowel resection and is being dismissed. The nurse determines that teaching goals have been met when the client indicates that s/he will watch for manifestations of
a. chronic constipation. b. fatigue and weakness. c. Heberden's nodules. d. malabsorption syndrome.
An adult with schizophrenia is discharged from a state mental hospital after 20 years of institutionalization. When planning care in the community, which premise applies? This patient is likely to
a. independently find support services to aid transition from hospitalization to community. b. adjust smoothly to the community if provided with sufficient support services. c. self-administer antipsychotic medications correctly if provided with education. d. need crisis or emergency psychiatric interventions from time to time.
The nurse enters a patient's room to complete the discharge paperwork and finds the patient in tears. The patient reports that someone from the business office stated they could not leave the hospital until the bill was paid
What is the best nursing action? a. Comfort the patient and continue the preparations for discharge. b. Call the social worker for a financial evaluation. c. Call the family to arrange for the payment. d. Cancel the discharge plans and notify the physician of the situation.
A nurse was employed by the Marine Hospital Service in 1800. Which of the following interventions would the nurse most likely have completed?
a. Setting policy on quarantine legislation for immigrants b. Establishing hospital-based programs to care for the sick at home c. Identifying and improving environmental conditions d. Providing health care for merchant seamen