An elderly client with a diagnosis of chronic bronchitis is being treated with scheduled and PRN administration of albuterol, an inhaled bronchodilator
After administering this drug, which of the client's vital signs should the nurse monitor closely because of potential adverse effects of this drug? Select all that apply. A) Temperature
B) Blood pressure
C) Respiratory rate
D) Heart rate
E) Oxygen saturation
B, D
Feedback:
Monitoring heart rate and blood pressure of older adults who use inhaled bronchodilators is important because these medications commonly cause tachycardia and hypertension. Either or both of these effects increase the risks for complications, especially in older adults with underlying cardiovascular disease.
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The nurse has established as an expected outcome that a client will "demonstrate healing of a stage II pressure ulcer over the coccyx." Which finding indicates that the client failed to achieve this outcome?
A) The rubber doughnut pressure relief device was not delivered by central supply. B) The client's serum albumin increased over the last month. C) A right side-back-left side-back turning schedule was utilized. D) Nurses did not document disinfection of the wound with alcohol with each dressing change.
A client is receiving chemotherapy with paclitaxel for breast cancer. A priority nursing intervention is to
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The nurse completes a thorough assessment of a patient and analyzes the data to identify nursing diagnoses. Which step will the nurse take next in the nursing process?
a. Assessment b. Diagnosis c. Planning d. Implementation
A 62-year-old male has fallen while trimming tree branches sustaining tissue injury. He describes his condition as an aching, throbbing back. This is characteristic of what type of pain?
a. Neuropathic pain b. Nociceptive pain c. Chronic pain d. Mixed pain syndrome