The assessment made by the nurse caring for a patient just returned from surgery following a surgical decompression of the carpal tunnel that would require immediate remedy is:
a. fingers swollen and warm.
b. complaint of pain.
c. capillary refill of 8 seconds.
d. fingers rosy.
C
A capillary refill of over 5 seconds is an indication of diminished perfusion. Pain and swelling are to be expected.
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While measuring a patient's blood pressure, the nurse uses the proper technique to obtain an accurate reading. Which of these situations will result in a falsely high blood pressure reading? Select all that apply
a. The person supports his or her own arm during the blood pressure reading. b. The blood pressure cuff is too narrow for the extremity. c. The arm is held above level of the heart. d. The cuff is loosely wrapped around the arm. e. The person is sitting with his or her legs crossed. f. The nurse does not inflate the cuff high enough.
The nurse is planning care for an older patient who is dying. Which interventions will ensure the patient dies with dignity? Standard Text: Select all that apply
1. Relieving suffering 2. Controlling pain and symptoms 3. Making decisions for the patient and family 4. Clarifying goals of treatment and the patient's values 5. Communicating patient needs between healthcare providers
If the amount of hydrogen peroxide for 100 mL ¼ strength hydrogen peroxide in normal saline is 25 mL,
then the amount of normal saline is 75 mL. Step B Calculate: determine the amount of solute needed C = ¼, V = 100 mL ¼ x 100 mL= St (solute) 25 mL = the amount of hydrogen peroxide Determine the amount of solvent needed V - St = Sv 100 mL - 25 mL = Sv (solvent) 75 mL the amount of normal saline Step C 25 is ¼ the total volume and 25 + 75 = 100, the answer is reasonable. a. Topical solutions/irrigants b. Enteral feedings Indicate whether the statement is true or false
Which of the following conditions would produce a hyperresonant percussion note?
A) Large pneumothorax B) Lobar pneumonia C) Pleural effusion D) Empyema