The nurse is most concerned when the assessment of a 4-hour-old newborn reveals:
A) an axillary temperature of 97.2°F. B) a heart rate of 130. C) a respiratory rate of 50. D) that the newborn has not eaten for two hours.
A
You might also like to view...
Which of the following are necessary factors that support healthy erythropoiesis? (Select all that apply.)
a. Dietary magnesium b. Healthy bone marrow c. Adequate oxygen source d. Vitamin B12 e. Amino acids f. Vitamin B2
What assessment finding will the nurse expect to observe in a tetraplegic patient in spinal shock?
A) Absence of reflexes along with flaccid extremities B) Positive Babinski's reflex along with spastic extremities C) Hyperreflexia along with spastic extremities D) Spasticity of all four extremities
When teaching the pregnant woman with class II heart disease, the nurse should
a. Advise her to gain at least 30 lb. b. Explain the importance of a diet high in calcium. c. Instruct her to avoid strenuous activity. d. Inform her of the need to limit fluid intake.
What factors are primarily used when quantifying patient care required and staffing needs?
a. Number of patients per nurse b. Number of discharges c. Acuity and time required for care d. Number of admissions