A patient has experienced multiple fractures, including pelvic and long bone fractures. After 72 hours, the patient complains of tachypnea and dyspnea and is found to have cyanosis, tachycardia, confusion, and fever
Laboratory analysis reveals a normal complete blood count except for thrombocytopenia and progressive respiratory insufficiency. What is the nursing care priority?
A) Administer oxygen and monitor pulse oximetry.
B) Initiate low-molecular-weight heparin therapy.
C) Obtain cultures of all body substances.
D) Initiate fall and seizure precautions.
A
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A nurse would closely monitor which client for an increase in possible adverse reactions after administering propranolol? Select all that apply
A) Clients with asthma B) Clients with hyperlipidemia C) Clients with diabetes D) Clients with peptic ulcer disease E) Clients with migraine headaches
The nurse is reviewing antimalarial drug therapy with a patient and instructs the patient to watch for and report which potential adverse reactions?
a. Drowsiness b. Insomnia c. Visual disturbances d. Constipation
During the initial interview with a client in crisis, the initial priority is to:
A) Assess the adequacy of the support system. B) Assess for substance use. C) Determine the precise level of functioning. D) Evaluate the potential for self-harm.
The nurse caring for a patient who has just had an arteriovenous (AV) access created in his right forearm. Which finding(s) is/are important for the nurse to assess? (select all that apply.)
a. Presence of bruit on auscultation of the AV site b. Capillary refill in the left hand c. Blood pressure in the right arm d. Adequate elevation of the right arm e. Abdominal incision site