E.B., a 69-year-old man with type 1 diabetes mellitus (dM), is admitted to a large regional medical center
complaining of severe pain in his right foot and lower leg. The right foot and lower leg are cool and without
pulses (absent by doppler).
Arteriogram demonstrates severe atherosclerosis of the right popliteal artery
with complete obstruction of blood flow. despite attempts at percutaneous catheter-directed thrombolytic therapy with alteplase (tissue plasminogen activator [TPA]) over 48 hours and surgical thrombectomy, the foot and lower leg become necrotic. Finally, the decision is made to perform an above-the-knee
amputation (AKA) on e.B.'s right leg. e.B. is recently widowed and has a son and daughter who live nearby.
In preparation for e.B.'s surgery, the surgeons wish to spare as much viable tissue as possible. Hence, an
order is written for e.B. to undergo 5 days of hyperbaric therapy for 20 minutes bid.
What is the purpose of hyperbaric therapy?
What will be an ideal response?
It optimizes the viability of hypoxic tissue beds by the process of hyperoxygenation. It can
rejuvenate cells that are damaged but cannot restore cells that are already dead. Hyperbaric
oxygenation therapy is the process of administering oxygen to a patient enclosed in a chamber
at a pressure greater than sea-level pressure. This therapy allows oxygen to diffuse into the serum
rather than red blood cells (RBCs). The oxygen is then transported to the tissue via the serum, thus
bypassing narrowed blood vessels where RBCs cannot travel. Another benefit is that elevated
oxygen levels may stimulate angiogenesis, the production of new blood vessels.
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Which of the following is a primary source of client data?
a. client b. client's spouse, parent, or adult child c. initial source of data, whoever that may be d. health care provider
A patient, age 27, sustained thermal burns to 18% of her body surface area. After the first 72 hours, the nurse will have to observe for the most common cause of burn-related deaths, which is
a. shock. b. respiratory arrest. c. hemorrhage. d. infection.
An 11-year-old was abducted and raped by an unknown assailant. In the emergency department, the
victim is confused and crying. The personal reaction experienced by the nurse that could interfere with the victim's care would be a. empathy. b. concern. c. anger. d. understanding.
The cardiac care unit is putting together a clinical practice committee. To develop expertise in evidence-based practice processes, the members of the committee should have skills that include the ability to (select all that apply):
a. report results. b. perform research. c. critique and synthesize evidence. d. statistically analyze quality improvement. e. develop an implementation and evaluation plan.