The nurse is assessing an infant brought to the clinic because of diarrhea. The infant is alert but has dry mucous membranes. Which additional assessment data indicates to the nurse that the infant is experiencing an early to moderate stage of dehydration?
1. Bradycardia
2. Tachycardia
3. Increased blood pressure
4. Normal fontanels
2
Explanation:
1. Bradycardia is not a sign of dehydration.
2. Tachycardia is a sign that indicates moderate dehydration.
3. In dehydration, the blood pressure is hypotensive.
4. Fontanels would be sunken in moderate dehydration.
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What will the nurse advise when providing nutrition education to the pregnant client?
a. "Every day you need to have at least 6 ounces of protein from sources such as meat, fish, eggs, beans, nuts, soybean products, and tofu." b. "High-dose vitamin A supplements will promote optimal vision while preventing a common cause of blindness in neonates." c. "Meals such as sushi with a cold deli salad made with raw sprouts combine high-fiber foods with protein sources to meet multiple nutritional needs." d. "Vitamin and mineral supplements can meet your nutrient needs if you have inadequate intake because of nausea or a sensation of fullness."
The nurse manager is anticipating changes on the unit because of managed care. It is up to the manager to "sell" the staff on this care concept. A goal of managed care that the staff must understand is that managed care is:
a. Grounded in business theory. b. Useful for long-term patients only. c. Designed to reduce unit resources and staff. d. Not concerned with the best interests of clients.
In the role of patient advocate, you would:
a. ensure the patient does not make risky health decisions. b. interpret the health care environment for culturally diverse patients. c. act as a proxy for the patient in understanding and signing important consents. d. educate the patient to ensure compliance with the health care organization's goals.
The nurse does health teaching with a client who has acquired immune deficiency syndrome (AIDS) and who has been started on antiviral medications. The nurse recognizes that teaching has been effective when the client makes which statement?
1. "I will need to limit my travel to avoid people with other infections." 2. "I will need to be on a high-calorie diet to enhance the effect of the medication." 3. "I will still need to take precautions to avoid spreading the virus to others." 4. "I will not be able to continue working at my high-stress job anymore."