In the early stages of pneumonia, which respiratory outcome might the nurse expect to see?
1. decreased PaO2 and increased PaCO2
2. decreased PaO2 and normal PaCO2
3. increased PaO2 and increased PaCO2
4. normal PaO2 and elevated PaCO2
2
Rationale: In the early stages of pneumonia the alveolar surface area is reduced and the alveolar–capillary membrane begins to thicken causing diffusion abnormalities. Oxygen and carbon dioxide do not diffuse at the same rate. Carbon dioxide diffuses 20 times faster than oxygen; therefore, hypoxemia may be present with a normal PaCO2. Only when the condition progresses untreated will the PaCO2 rise.
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The parents of a child with transposition of the great vessels ask the nurse why the child looks blue. Which response by the nurse is the most appropriate?
A. "Her body gets blood that doesn't have much oxygen." B. "Her lungs are underdeveloped and underperfused." C. "She is not able to regulate her temperature and is cold." D. "This is very unusual for this condition, so I'll ask the doctor."
Which document refers specifically to the patient's Protection of Privacy?
a. ANA Code for Nurses b. International Council of Nurses' Code for Nurses c. Canadian Nurse Association's Code of Ethics for Nursing d. Patient Care Partnership
When using IA to assess uterine activity (UA), nurses should be aware that:
1. an examiner's hand should be placed over the fundus before, during, and after contractions. 2. the frequency and duration of contractions are measured in seconds for consis-tency. 3. contraction intensity is given a judgment number of 1 to 7 by the nurse and pa-tient together. 4. the resting tone between contractions is described as either placid or turbulent.
Follow-up teaching for a client who has just had a squamous cell carcinoma removed from the skin must include: Select all that apply
1. Inspecting the skin vigilantly on a routine basis. 2. Having caregiver inspect the hard-to-visualize areas of the body. 3. Reporting any suspicious-looking areas to the primary health care provider. 4. Using sunscreen routinely. 5. Covering areas where the cancer has occurred with clothing or hats.