You call the attending physician to notify the physician that your client, who has suffered a myocardial infarction, is dying
You have worked in the coronary care unit for 11 years, and you recognize the clinical picture of impending death. You are operating in which of Benner's stages of professional skill development?
1. advanced beginner
2. competent
3. proficient
4. expert
ANS: 4
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At a home visit, the nurse asks the patient, "Have you taken your blood pressure medicine today?" The patient replies, "I don't remember. Maybe." On the table are several bottles of medication, some open, some not
They have all been prescribed for the patient. The patient cannot say how often to take each one, when asked. A compartmentalized medication organizer is on the table, with a few capsules in it, and some compartments left open. What should the nurse do? a. Show the patient how to put the medications in the organizer for the next 2 days; observe while he fills the rest of the organizer. b. Arrange for a home health aide to come each day to show the patient which pills to take. c. Administer today's medications and arrange for the pharmacy to put medications in easy-to-open containers in the future. d. Fill the organizer for each day of the week; explain how to use it; and return in a day or two to evaluate.
The nurse uses a diagram to show that fluids in the interstitial and intravascular compartments are combined. What do they combine to form?
a. Intercellular compartment b. Circulating compartment c. Vertical compartment d. Extracellular compartment
A client is upset and complains of dizziness, tingling of fingers and toes, and lightheadedness. The nurse assesses a respiratory rate of 46 breaths per minute. Laboratory results show a pH of 7.50 and a PaCO2 of 28, values consistent with:
1. respiratory acidosis. 2. respiratory alkalosis. 3. metabolic acidosis. 4. metabolic alkalosis.
The next set of observations reveal the patient's BP has fallen to 95/70 mmHg. What should you do?
Mrs Lucia Caruso is a 31-year-old woman who has been admitted into the postanaesthesia care unit (PACU) following a dilation and curette after having had an incomplete missed abortion (miscarriage). On arrival, Mrs Caruso has a size 3 laryngeal mask airway (LMA) in situ, and is unconscious and in a supine position. A disposable t-piece and oxygen, 6 litres per minute, are connected to the LMA and monitoring is connected. You accept a full handover from the anaesthetist, who reports a fit and healthy patient and an uneventful procedure. An IV line is in situ in the back of the patient's left hand with a litre of Hartmann's solution running at an 8-hourly rate. You make your initial assessment and document the patient's vital signs as follows: airway clear, oxygen saturation 99%, respiratory rate 18 per minute, BP 130/90 mmHg (preoperative 120/80 mmHg) and heart rate regular at 74 bpm. Five minutes after arrival, Mrs Caruso stirs and opens her eyes and you remove the LMA and place her on 6 litres of O2 via a Hudson mask. Now that the patient is conscious, you continue your observations, taking and recording her core temperature (using a tympanic ear thermometer) at 36.2°C and assessing the per vaginal (PV) loss, which is slight and bright. You sit Mrs Caruso slightly head up to facilitate optimal ventilation. Mrs Caruso is understandably upset and so you comfort her. Her vital signs remain stable and so after 15 minutes you remove her oxygen and trial her on room air. Mrs Caruso appears stable: SaO2 97% on room air, BP 115/85 mmHg, respirations 20 per minute and heart rate 70 bpm. No further PV loss is present and so you conclude that your patient is ready to be transported to the ward. You decide to record the next set of observations (due in 2 minutes) on the ward observation chart and then you will call the ward nurse to collect Mrs Caruso. What will be an ideal response?