A patient with heart failure is anxious to recover quickly. After ambulating with the UAP, the nurse observes that the patient has dyspnea. The nurse asks the patient to rate her exertion on a scale of 1 to 20 and the patient says, "I can keep going. It's only about a 15." What is the nurse's best response?
a. "Slow down a bit; ideally you should be less than 12"
b. "As long as you are less than 18, you can keep going"
c. "Stop right now; you should not tax your heart beyond 5"
d. "You should go slower; you cannot reach level 0 in one day"
Answer: a. "Slow down a bit; ideally you should be less than 12"
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A patient with a 10-year history of alcoholism was admitted to the critical care unit with the diagnosis of acute pancreatitis. Based on the diagnosis, the patient
a. is at risk for hypovolemic shock from plasma volume depletion. b. requires observation for hypoglycemia and hypercalcemia. c. should be started on enteral feedings after the nasogastric tube is placed. d. is placed on a fluid restriction to avoid the fluid sequestration.
A patient with acute congestive heart failure has jugular vein distention, crackles bilaterally, and dyspnea. Which nursing diagnosis should have the highest priority?
a. Activity intolerance b. Excess fluid volume c. Anxiety d. Ineffective coping
A client is reporting intermittent pain in the left upper abdomen. In order to best assess the characteristics of the pain, the nurse asks the client: Select all that apply
1. "Can you do anything that makes the pain go away?" 2. "Does anything make the pain worse?" 3. "When did you first notice the pain?" 4. "Can you describe the pain for me?" 5. "What do you think is causing the pain?"
It has been established that many people over 50 years have low serum levels of vitamin B12 . Where is it recommended that older adults get most of their vitamin B12 from?
A) Citrus fruits and juices C) Milk and dairy products B) Red meats D) Fortified cereals