A client diagnosed with a spinal cord injury has been experiencing spinal shock. Which of the following assessment findings would indicate that this shock is resolving?
1. Blood pressure 80/55 mmHg
2. Heart rate 48 beats per minute
3. Reflexive emptying of the bladder
4. Body temperature 97°F
3
Resolution of spinal shock is indicated by return of reflexes, replacement of flaccidity with hyperreflexes, and reflexive emptying of the bladder. Low blood pressure, low heart rate, and low body temperature are all indications of neurogenic shock, which is an aspect of spinal shock.
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During the 7th month of pregnancy, a client exhibits dependent edema. The nurse explains the treatment for fluid retention during pregnancy, which is
a. adequate fats b. avoidance of salty foods c. elevation of the lower extremities d. low-sodium diet and elevation of the extremities
The nurse working on a community initiative to respond to pandemic flu would design priority interventions that would
a. bolster the communication network with the federal government. b. educate the public on what to do in a pandemic. c. limit person-to-person transmission. d. provide antiviral medications to every person in the community.
Why is it important for the nurse to understand the type of family that a client comes from? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply
1. Family structure can influence finances. 2. Some families choose to conceive or adopt without a life partner. 3. The nurse can anticipate which problems a client will experience based on the type of family the client has. 4. Understanding if the client's family is nuclear or blended will help the nurse teach the client the appropriate information. 5. The values of the family will be predictable if the nurse knows what type of family the client is a part of.
Methicillin resistant S. aureus (MRSA) is still largely a hospital-acquired infection. Community health nurses should know:
1. Persons with MRSA usually have a chronic illness. 2. MRSA is still a nosocomial (health-care acquired) infection and not often seen in the community. 3. VRE (Vancomycin resistant Staphylococcus aureus) follows MRSA. 4. MRSA is becoming more common in the community, especially in school athletic programs and prison populations.