Your patient, who abuses intravenous (IV) drugs, has a sudden onset of fever and symptoms of congestive heart failure. Inspection of the skin reveals nontender erythematic lesions to the palms. These findings are consistent with the development of:
a. rheumatic fever.
b. cor pulmonale.
c. pericarditis.
d. endocarditis.
D
Endocarditis is a bacterial infection of the endothelial layer of the heart. It should be suspected with at-risk patients (e.g., IV drug abusers) who present with fever and sudden onset of conges-tive heart symptoms. The lesions described are Janeway lesions.
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The notion of staggering the implementation of the system is determined during the planning phase by committee members. The rationale behind staggering the implementation of the new system can be related to which of the following statements?
1. The decision to incorporate a roll out model of implementation can be used to identify issues before the entire system goes live. 2. Staggering allows staff members to become more familiar with the new technology. 3. Budgetary constraints are the main factors in determining whether a system should be staggered or fully implemented. 4. Nurses and staff need additional time to accept an unwanted technological change.
During auscultation of the thorax, the nurse hears a low-pitched creaking sound. What should be the nurse's next action?
1. Have the patient cough to attempt to clear the sound. 2. Have the patient turn to the left side. 3. Collaborate with the physician regarding a chest X-ray. 4. Ask the patient to hold her breath.
What is true of sexuality?
a. It becomes absent with age. b. It remains part of life until death. c. As expressed through intercourse is not possible after the age of 65 years. d. It must be expressed in sexual intercourse.
What is an important teaching point for an older patient prescribed primidone (Mysoline)?
a. This drug may cause very high fevers. b. You may develop a severe rash with this drug. c. Your ankles are likely to swell while you are taking this drug. d. Primidone can cause development of unusual restlessness and excitement.