The nurse assesses the patient's intravenous (IV) infusion. Which clinical indicator cues the nurse to take special precautions while infusing IV fluids?
a. Poor skin turgor
b. Bilateral crackles
c. Mild hypotension
d. High serum sodium
B
The nurse scrutinizes IV therapy for patients with crackles in the lungs because it is consistent with clinical indicators of fluid overload and pulmonary edema. In fact, crackles consistently in-dicate fluid of some type in the lungs and are a classic sign of fluid overload. As a result, the nurse administers IV fluids to the patient with heightened scrutiny to avoid administering excess IV fluids. Poor skin turgor, hypernatremia, and hypotension indicate a potential need for addi-tional fluid volume.
You might also like to view...
The most important function of type I alveolar epithelial cells is
a. that they comprise 90% of total alveolar surface in the lungs for gas exchange. b. the ability to produce, store, and secrete pulmonary surfactant. c. the ability to trap foreign particles for autodigestion. d. the maintenance, repair, and restoration of the mucociliary escalator.
Which sampling method would be most practical and provide the most reliable data to study the ethical conflicts experienced by registered nurses who work in city, county, and federal prisons?
1. Purposive sampling. 2. Cluster random sampling. 3. Quota sampling. 4. Simple random sampling.
The nurse is providing care for a client who is taking acetaminophen (Tylenol). What should the nurse pay particular attention to during the assessment?
1. Respiratory rate 2. Pulse rate 3. Blood pressure 4. Severe upper or lower abdominal pain
A patient in Russell traction with a Pearson attachment for a fracture of the tibia complains of intense pain at the fracture site. The nurse assesses a temperature of 102° F and increased swel-ling at the fracture site
Which complication do these findings suggest? a. Osteomyelitis b. Fat embolism c. Traction misalignment d. Nonunion of the fracture