The nurse has just completed an infusion of a 1000 mL bolus of 0.9% normal saline in a patient with severe sepsis. One hour later, which laboratory result requires immediate nursing action?
a. Creatinine 1.0 mg/dL
b. Lactate 6 mmol/L
c. Potassium 3.8 mEq/L
d. Sodium 140 mEq/L
B
Lactate level has been used as an indicator of decreased oxygen delivery to the cells, adequacy of resuscitation in shock, and as an outcome predictor. All other listed values are within normal limits and do not require additional follow-up.
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A client with a history of peptic ulcer disease is admitted for hematemesis associated with gastric bleeding. Which is the most appropriate action of the nurse?
A) Administer oxygen. B) Increase intravenous flow rate. C) Prepare for nasogastric irrigations. D) Lower the head of the bed.
Components of a receptive context for EBP include what? (Select all that apply.)
a. Strong leadership b. Clear strategic vision c. Effective data-capture systems d. Organizational skills e. Good managerial relations f. Visionary staff in key positions g. Ability to prioritize h. Climate conducive to experimentation and risk taking
The nursing student asks the nurse about nurse-initiated and physician-initiated interventions. Which of the following is a physician-initiated intervention?
A) Teach client how to transfer from bed to chair and chair to bed. B) Administer oxygen 4 L/min per nasal cannula. C) Assist the client with coughing and deep breathing every hour. D) Monitor intake and output every 2 hours.
What antiplatelet agent is most widely used for secondary prevention of stroke?
a. Aspirin c. Clopidogrel b. Ticlopidine d. Aspirin and clopidogrel