The nurse is caring for a postoperative patient who becomes restless, hypotensive, tachycardic, and tachypneic. Which nursing action should be given priority?
a. Notify the patient's family.
b. Ensure physician is informed.
c. Monitor vital signs.
d. Maintain a patent airway.
ANS: D
The patient is obviously experiencing a complication and must be carefully monitored to ensure that a patent airway is maintained while vital signs are obtained, and then the physician and family should be informed.
You might also like to view...
The nurse is preparing the patient with heart failure for discharge. During the patient teaching session, the nurse realizes that the patient will require further teaching in relationship to taking valsartan (Diovan) when the patient states:
A) "I will notify my physician if I have dizziness when I stand up." B) "If I notice a change in the amount that I urinate, I will call my doctor." C) "I will call my doctor if I have weakness in my legs." D) "I will use these prescriptions for blood work when I notice side effects from the medication."
The health care provider prescribes sertraline to a client for depression. The nurse understands that this agent acts as a/an:
a. monoamine oxidase inhibitor. b. selective serotonin reuptake inhibitor (SSRI). c. benzodiazepine. d. tricyclic antidepressant.
While interviewing a client, a nurse is told that the client practices Catholicism. This client is identifying:
a. his spirituality. b. his culture. c. his faith. d. his values.
____________________ is a condition in which there is insufficient oxygen in the blood.
Fill in the blank(s) with the appropriate word(s).