The nurse is reading a computer printout of the results of a cerebrospinal fluid (CSF) analysis performed on an adult client who has undergone lumbar puncture
Evaluation of the results by the nurse leads to the determination that which of the following CSF findings is abnormal? 1. Red blood cells, 0
2. Glucose, 52 mg/dL
3. Protein, 100 mg/dL
4. White blood cells, 3 cells/mm3
3
Rationale: Protein (15 to 45 mg/dL) and glucose (50 to 75 mg/dL) normally are present in CSF; however, the protein level is above the expected range. The adult with normal CSF has no red blood cells in the CSF. The client may have small numbers of white blood cells (0 to 5 cells/mm3).
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It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, when should the client receive RhoGAM?
A) At 32 weeks' gestation and immediately before discharge B) 24 before delivery and 24 hours after delivery C) In the first trimester and within 2 hours of delivery D) At 28 weeks' gestation and again within 72 hours after delivery
A patient has the following arterial blood gas (ABG) results. In analyzing the data, the nurse recognizes the patient has what health problem?
1. metabolic acidosis 2. metabolic alkalosis 3. respiratory acidosis 4. respiratory alkalosis
A client sustained several wounds on the legs caused by a fall. On the day after the injuries, the wounds appear red and edematous. The nurse identifies the stage of healing of these wounds as being:
1. Inflammatory. 2. Proliferative. 3. Maturation. 4. Remodeling.
What are your nursing priorities at this time?
What will be an ideal response?