The nurse is caring for a pt with a temp of 103 F, respirations of 30 per min., pulse rate of 50 beats per minute, and BP of 100/60. The pt is cold and clammy. What does the nurse conclude abt these findings?
a. The temp is causing a lowered pulse rate; it will improve if the temp. decreases.
b. The low pulse rate is causing a decreased cardiac output, which has caused a low BP
c. The pulse rate and BP are compensatory mechanisms to decrease the increased metabolic rate from the temp.
d. The cool, clammy skin will help to increase the BP and pulse as the body tries to warm the skin
b. The low pulse rate is causing a decreased cardiac output, which has caused a low BP
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The postpartum client is concerned about mastitis because she experienced it with her last baby. Preventive measures the nurse can teach include which of the following?
1. Wearing a tight-fitting bra 2. Limiting breastfeedings 3. Frequent breastfeedings 4. Restricting fluid intake
The health maintenance focus for the patient in tertiary care is to
a. regain or attain as much independence as possible. b. extend the time in tertiary care as long as possible. c. ensure total independence with self-care. d. avoid acquired infections while in the tertiary facility.
The nurse is responsible for making the first home evaluation and developing a patient care plan that can be followed by the home health aide
Indicate whether the statement is true or false.
The nurse is helping a client with teeth flossing. What should the nurse instruct the client to do with the dental floss?
1. Wrap the length of dental floss around the wrist 2. Make a knot at the end of a length of dental floss 3. Weave the dental floss between the upper row of teeth 4. Wrap one length of floss loosely around index fingers of both hands