When learning how to implement the nursing process into a plan of care for a client, the student nurse realizes that part of the purpose of the nursing process is to:
A) Identify client needs and deliver care to meet those needs.
B) Make sure that standardized care is available to clients.
C) Implement a plan that is close to the medical model.
D) Deliver care to a client in an organized way.
A
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A 36-year-old patient diagnosed with meningitis has a fever of 102.3° F. A family member verbalizes a concern that the patient is "breathing fast
" Upon assessment, the nurse notes a respiratory rate of 20 breaths/min, pulse oximetry is 92% on 2L/O2, and lungs clear to auscultation. What is the best explanation for the rapid respiratory rate that the nurse can give the family member? a. "He is most likely anxious because he is in the hospital." b. "His fever has increased his metabolic rate and is causing him to breathe faster." c. "He is hyperventilating because he needs more oxygen." d. "He has an acid-base imbalance, which is causing him to hyperventilate."
Which nonbarbiturate anesthetic when used with halothane (Fluothane) can cause severe cardiac depression?
A) Droperidol (Inapsine) B) Etomidate (Amidate) C) Ketamine (Ketalar) D) Propofol (Diprivan)
The nurse assesses the client and establishes a preoperative nursing diagnosis of Potential for altered peripheral tissue perfusion
Which does the nurse include in client teaching to prevent decreased perfusion to the client's extremities while the client is on bed rest? 1. Avoid fluids by mouth until all nausea passes. 2. Flex and rotate ankles every hour while awake. 3. Rest quietly to allow opioid analgesics to work. 4. Keep environmental distractions to a minimum.
A 39-year-old man is at the gym exercising and develops a pain in his upper right quadrant. The paramedics are called; their initial vital-sign readings indicate a pulse of 175 beats/min. This pulse would be considered what? (Mark all that apply.)
A) Elevated due to pain B) Elevated due to age C) Elevated due to gender D) Elevated due to activity E) Elevated due to weight