A patient is admitted with symptoms of an ischemic stroke. After further evaluation, it is determined that the patient is not a candidate for thrombolytic therapy
What interventions would be appropriate to reduce the patient's blood pressure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Assess for pain when measuring blood pressure.
2. Assess for bladder distention.
3. Assess neurologic function with every blood pressure assessment.
4. Administer medication to reduce blood pressure by 15% over 24 hours.
5. Provide antihypertensive medication to reduce pressure to normal levels.
1,2,3,4
Rationale 1: When blood pressure is elevated the nurse should assess for factors such as pain that can contribute to the patient's hypertension.
Rationale 2: When blood pressure is elevated the nurse should assess for factors such as bladder distention that can contribute to the patient's hypertension.
Rationale 3: While treating the elevated blood pressure, continual reassessment of neurologic function is recommended.
Rationale 4: When treatment is needed, blood pressure should be lowered by about 15% over the first 24 hours.
Rationale 5: Blood pressure should be lowered by about 15% over the first 24 hours and not to normal levels since this could cause cerebral hypoperfusion.
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When teaching a client about the recommended serum cholesterol level for an adult, the nurse instructs the client to try to achieve:
a. HDL of 35mg/dL. c. cholesterol level of 170 mg/dL. b. Hemoglobin level of 20 g/dL. d. triglyceride level of 200 mg/dL.
Two days after an acute myocardial infarction (MI), a patient complains of stabbing chest pain that increases with a deep breath. Which action will the nurse take first?
a. Auscultate the heart sounds. b. Check the patient's temperature. c. Notify the patient's health care provider. d. Give the PRN acetaminophen (Tylenol).
Which of the following statements by a client indicates a lack of understanding regarding an appropriate reason to sue for malpractice?
a. "Because the health care workers didn't turn my mother every 2 hours, she developed bedsores." b. "I received permanent nerve damage because they would not remove a cast that was too tight." c. "My daughter wasn't given a call light, and for a whole shift no one checked on her condition." d. "They amputated the wrong leg during surgery."
Which information should the nurse include in the teaching for the client prescribed long-term corticosteroid therapy?Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A. Avoid carbonated beverages. B. Participate in regular weight-bearing exercises. C. Avoid taking calcium supplements. D. Take your prescription with food or milk. E. Avoid caffeine in the diet.