The client is in atrial fibrillation following cardiac surgery. Which of the following assessment parameters should the nurse monitor for complications associated with this dysrhythmia?
A. Measure urinary output.
B. Assess for shortness of breath.
C. Assess pulse oximetry every hour.
D. Measure blood pressure in the lying and sitting positions.
B
A serious and frequent complication of atrial fibrillation is systemic emboli, particularly pulmo-nary emboli. The nurse should assess for shortness of breath, chest pain, and hemoptysis because they are symptoms of pulmonary emboli.
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The nurse is caring for a client with emphysema. When the nurse enters the client's room, the spouse asks for the oxygen to be increased, because the client is having trouble breathing. The nurse's best intervention is to:
1. Call the physician for an order to increase the oxygen delivered. 2. Increase the oxygen and monitor oxygen saturation. 3. Explain that increased oxygen will decrease respirations and make him more SOB. 4. Tell the spouse that increasing oxygen is not possible.
The nurse is planning care for a new client who has been admitted to the unit with early dementia. The nurse should plan interventions to meet the priority of care for the client which is:
1. the client's airway. 2. the client's elimination. 3. the risk for pressure ulcers. 4. the client's safety.
How does the drug diltiazem (Cardizem) lower blood pressure?
a. Prevents angiotensin from binding to its receptors b. Blocks nerve stimulation of blood vessels c. Increases water and sodium loss d. Widens small arteries
The nurse is assisting a client to the bathroom when the client begins to have a tonic-clonic seizure. Which is the first thing that the nurse should do at this time?
A. Assist the client back to bed. B. Take the client's vital signs. C. Time the seizure. D. Remove the client's clothing.