The nurse notes that the handgrip of the client with hypokalemia has diminished since the previous assessment one hour ago. Which intervention by the nurse is the priority?
a. Assess the client's respiratory rate, rhythm, and depth.
b. Measure the client's pulse and blood pressure.
c. Document findings and monitor the client.
d. Call the health care provider.
A
In a client with hypokalemia, progressive skeletal muscle weakness is associated with increasing severity of hypokalemia. The most life-threatening complication of hypokalemia is respiratory insufficiency. It is imperative for the nurse to perform a respiratory assessment first to make sure that the client is not in immediate jeopardy. Next, the nurse would call the health care provider to obtain orders for potassium replacement.
You might also like to view...
Which of the following normal aging changes increase an older adult's risk of falling?
a. Decreased cardiac output b. Decreased aerobic reserve c. Visual changes d. Cognitive changes
A patient is being discharged from a health care facility but is required to continue antiviral therapy at home. Which of the following points should the nurse include in the teaching plan to educate the patient?
A) "A slight elevation in temperature is normal and needn't be reported." B) "Double the dosage of the drug if you miss a dose." C) "Stop taking the drug as soon as the symptoms of the infection disappear." D) "Make sure to notify your primary health care provider if you develop any adverse reactions."
When a nurse assesses an older adult patient, answers seem vague or unrelated to the questions. The patient also leans forward and frowns, listening intently to the nurse. An appropriate question for the nurse to ask would be:
a. "Are you having difficulty hearing when I speak?" b. "How can I make this assessment interview easier for you?" c. "I notice you are frowning. Are you feeling annoyed with me?" d. "You're having trouble focusing on what I'm saying. What is distracting you?"
A patient recently diagnosed with schizophrenia is taking antipsychotic medication to control hallucinations. Which is an appropriate activity for level 2 of wellness that could be included in this patient's treatment? (Select all that apply.)
1. Referral to a job training program 2. Medication management education 3. Group therapy 4. Inpatient admission 5. Family support group