A client develops peritonitis as a result of a ruptured appendix. The nurse should carefully monitor the client for evidence of which of these complications?
a. hypothermia c. hepatitis
b. thrombosis d. paralytic ileus
D
Peritonitis is a life-threatening condition that is evidenced by vomiting, abdominal pain and distention, and absence of bowel sounds. Surgical management includes repairing the cause of peritoneal irritation, decompressing the abdomen, and inserting abdominal drains. Analgesics and antibiotics are prescribed, and the client has no oral intake of food and fluids until bowel sounds return. Nursing care of clients who have peritonitis include managing pain, monitoring fluid volume and respiratory status, monitoring for paralytic ileus, and providing comfort measures.
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A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?
A) By promoting the rapid excretion of vitamin K by the gastrointestinal mucosa B) By inhibiting the action of vitamin K at its sites of action C) By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis D) By inactivating clotting factors and thus stopping the coagulation cascade
Which of the following best describes how care can be appropriately given in a community?
a. Provide individualized care to unique individuals as much as resources allow. b. Consider the community itself as the "client." c. Administer care according to the priorities of the local health department. d. Prioritize care for the sickest populations first.
Monitoring of a patient who is on a lipid-lowering drug includes:
1. Fasting total cholesterol every 6 months 2. Lipid profile with attention to serum LDL 6 to 8 weeks after starting therapy, then again in 6 weeks 3. Complete blood count, C-reactive protein, and erythrocyte sedimentation rate after 6 weeks of therapy 4. All of the above
Which of the following is an example of the role of the nurse as counselor?
1. A home health nurse contacts adult protective services for a client who is being neglected. 2. A nurse in a homeless clinic discusses the importance of good foot care with a man with severe blisters. 3. An occupational health nurse works with a client to examine strategies on how to stop smoking. 4. A school nurse holds a class on contraception for 10th grade girls.