A client who experiences fatigue, elevated temperature, and confusion after running a marathon has a urine specific gravity of 1.039. What should the nurse suspect be occurring with this client?
a. Euhydration
b. Dehydration
c. Water toxicity
d. Overhydration
b. Dehydration
Normal specific gravity values are 1.002—1.028. A urine specific gravity of 1.030 or greater is a sign of dehydration. This diagnosis is supported by complaints of confusion, fatigue, and elevated temperature. Overhydration and water toxicity are terms used to describe an excessive intake of water, a condition usually found in clients with schizophrenia and other mental illnesses. Euhydration is a state of balanced body fluids.
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An infant is prescribed oxybutynin chloride (Ditropan) for neurogenic bladder. What should the nurse instruct the parents about this medication?
A) This medication has no adverse effects. B) Check the child frequently for sweating. C) Schedule appointments with the health care provider when necessary. D) Provide the child with the medication when urinary output is sluggish.
A patient who is scheduled for a partial laryngectomy asks if he will still be able to talk after the surgery
What are appropriate nursing responses to this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "No, you will not.". 2. "You will have to ask your physician.". 3. "Yes, but it might sound a little different.". 4. "You will be able to talk, but with an electronic device.". 5. "Speech is usually preserved, but we will know better after surgery.".
A mother and two children are in the emergency department. She has just escaped from a severe beating by her husband. What is the nurse's priority intervention?
a. Appeal to her maternal instincts regarding child care. b. Focus on physical safety and emotional security. c. Provide a support group referral. d. Disclose victims' legal rights.
Which intervention should the nurse plan to implement when caring for a client who has just undergone a right above-the-knee amputation?
A) Maintain the residual limb on three pillows at all times. B) Place a large tourniquet at the client's bedside. C) Apply constant, direct pressure to the residual limb. D) Do not allow the client to lie in the prone position.