A patient is demonstrating pulmonary edema, hypotension, and delayed capillary refill. The nurse suspects the patient is experiencing which type of shock?
1. Hypovolemic
2. Cardiogenic
3. Anaphylactic
4. Obstructive
2
Rationale 1: Pulmonary edema would not be present in hypovolemic shock.
Rationale 2: In cardiogenic shock, there is a low cardiac output, hypotension, and pulmonary edema.
Rationale 3: Pulmonary edema would not be present in anaphylactic shock.
Rationale 4: Pulmonary edema would not be present in obstructive shock.
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A nurse assesses an older adult client who has multiple chronic diseases. The client's heart rate is 48 beats/min. Which action should the nurse take first?
a. Document the finding in the chart. b. Initiate external pacing. c. Assess the client's medications. d. Administer 1 mg of atropine.
The nurse is assessing a patient who is taking oxybutynin (Ditropan). What would be the priority nursing assessment for this patient?
A) Skin condition B) Cardiac arrhythmia C) Vision changes D) Mental status
A nurse is presenting a class at a bariatric clinic about the different types of surgical procedures offered by the clinic
When describing the implications of different types of surgeries, the nurse should address which of the following topics? Select all that apply. A) Specific lifestyle changes associated with each procedure B) Implications of each procedure for eating habits C) Effects of different surgeries on bowel function D) Effects of various bariatric surgeries on fertility E) Effects of different surgeries on safety of future immunizations
The nurse documents: "Client avoids eye contact and gives only vague, nonspecific answers to direct questioning by the professional staff. Is quite animated (laughs aloud, smiles, uses hand gestures) in conversation with spouse."
Which method of data collection does this documentation demonstrate? 1. Examining 2. Interviewing 3. Listening 4. Observing