You pull the covers back to inspect the abdominal dressing and find that the original surgicaldressing is saturated with fresh bloody drainage
What are the priority actions?
Reinforce the dressing with a heavy drainage dressing (trauma dressing or ABD dressing), check
C.W.'s VS and stay with her, and have someone else call the physician. Initiate treatment for shock,
and notify the rapid response team if appropriate.
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The nurse is caring for a patient who will be undergoing upper GI series testing the next day. Which instruction will the nurse provide to the patient about the upcoming exam?
a. "The back of your throat will be sprayed with numbing medicine." b. "You will need to have a clear liquid diet and take a laxative tonight." c. "You will be given a milky liquid to drink shortly before the test starts." d. "You should not take your dose of warfarin (Coumadin) tonight."
Which statement is correct regarding the use of glycoprotein IIb/IIIa inhibitors?
a. They facilitate the final step in platelet aggregation. b. They are used as adjuncts with thrombolytic therapy. c. They are contraindicated in patients undergoing angioplasty. d. They should be continued for 12 hours after percutaneous coronary intervention.
The nurse arrives at work to find the unit will be short staffed for the shift because a nurse called in sick at the last minute, leaving no time to find a replacement
What factors contribute to the dilemma faced by the nurse working this shift? Select all that apply. a. The nurse's multiple obligations and relationships b. Value conflicts and lack of clarity within the profession c. Autonomy versus escaping hard choices d. Higher pay versus cost effectiveness e. Caring versus the decreased time to spend with patients
The nurse is assessing a pregnant client who is at 29 weeks gestation. The nurse notes that the client's blood pressure is 160/90 and documents that the clonus was noted after assessing the patellar reflex. Which assessment findings led the nurse to document this finding?
A. There was no response when the area directly above the knee was struck with the percussion hammer. B. The nurse noted an extension of the leg when the percussion hammer touched the area above the knee. C. The client complained of pain when the foot was dorsiflexed. D. The client's foot tapped against the nurse's hand when it was dorsiflexed.