The nurse is caring for a patient in septic shock. The nurse assesses the patient to have a blood pressure of 105/60 mm Hg, heart rate 110 beats/min, respiratory rate 32 breaths/min, oxygen saturation (SpO2) 95% on 45% supplemental oxygen via Venturi
mask, and a temperature of 102° F. The physician orders stat administration of an antibiotic. Which additional physician order should the nurse complete first? a. Blood cultures
b. Chest x-ray
c. Foley insertion
d. Serum electrolytes
A
Timely identification of the causative organism through blood cultures and the initiation of appropriate antibiotics following obtaining blood cultures improve the survival of patients with sepsis or septic shock. A chest x-ray, Foley insertion, and measurement of serum electrolytes may be included in the plan of care but are not the priority in this scenario.
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An 80-year-old patient fell and fractured her hip and is in the hospital. Before the fall, she lived at home with her husband and managed their activities of daily living very well
The goal is for the patient to recover from the injury and return to her home. The hospital is ready to discharge her because she has exceeded the recommended length of stay in a hospital. However, she cannot walk or care for herself yet, and she will require lengthy physical therapy and further monitoring of her medications and her physical and mental status. To which type of facility should she be transferred? 1) Nursing home 2) Rehabilitation center 3) An outpatient therapy center 4) None of these; she should receive home healthcare
The parents of a 2-year-old child tell the nurse they are concerned because the toddler has started to use "baby talk" since the arrival of their new baby. What should the nurse recommend?
a. Ignore the baby talk. b. Tell the toddler frequently, "You are a big kid now." c. Explain to the toddler that baby talk is for babies. d. Encourage the toddler to practice more advanced patterns of speech.
The chief nursing officer understands that clinical incompetence is best prevented by a(n):
a. Flexible protocol for evaluating competency skills. b. Standardized clinical skills checklist. c. Administration of personality tests and competency assessments at point of hire. d. Formalized competency program with established standards for practice.
A patient is to receive methylprednisolone (Solu-Medrol) 100 mg. The label on the medication states: methylprednisolone 125 mg in 2 mL. How many milliliters will the nurse administer?
What will be an ideal response?