The nurse caring for a client with acute renal failure realizes that a complication has occurred during the diuretic stage of the disorder when the client exhibits signs of: Select all that apply
1. Hypovolemia.
2. Hypotension.
3. Infection.
4. Hyperkalemia.
5. Hypernatremia.
1. Hypovolemia.
2. Hypotension.
3. Infection.
Rationale: Hypovolemia. The client will have large amounts of urine output, as high as 1 to 2 liters/day. This places the client at risk for hypovolemia. Hypotension. The client will have large amounts of urine output, as high as 1to 2 liters/day. This places the client at risk for hypotension. Infection. The client can exhibit signs of infection during any phase of acute renal failure. Hyperkalemia. The client will exhibit signs of hypokalemia with the excessive amounts of urine output. Hypernatremia. The sodium level would decrease in this phase.
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A nurse assesses a client who has mitral valve regurgitation. For which cardiac dysrhythmia should the nurse assess?
a. Preventricular contractions b. Atrial fibrillation c. Symptomatic bradycardia d. Sinus tachycardia
Nurses on the dialysis unit notice that changes in labeling of fluids have meant several alarming near misses in terms of wrong administration of fluids
They take this concern to the unit manager. As an advocate of nurse autonomy, the most appropriate response in this situation would be to: a. Ensure that the nurses are aware of the reasons for the change and how the decision was made about the new labels. b. Discuss concerns about the labels and develop potential solutions that take into account changes that can be made at the local level and those that need system intervention. c. Suggest that the staff wait until they have become more familiar with the labels before taking further action. d. Tell the staff that you will notify the pharmacy about these concerns and leave it up to the pharmacy to decide what should be done.
According to the nurse practice act, the nurse is liable for
A) Writing a physician order B) Clarifying a physician order C) Administering what is written D) Determining the dosage
The steps of the ethical decision making process are similar to the steps of
a. Healthy People 2010 b. Deontology c. The nursing process d. Advocacy