The nurse is caring for a client who has undergone esophageal dilation for achalasia. Two hours later, the client develops chest and shoulder pain. What would be the nurse's best ac-tion?
A. Administer an analgesic.
B. Document the finding as the only action.
C. Reposition the client.
D. Notify the physician.
D
The client may be experiencing complications of the procedure, such as bleeding and perforation. These complications require immediate intervention.
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An 82-year-old man is admitted to a medical-surgical unit for diagnostic confirmation and management of probable delirium. Which of the following statements by the client's daughter best supports the diagnosis?
1. "Dad has always been so independent. He's lived alone for years since my mom died." 2. "Dad just didn't seem to know what he was doing. He would forget what he had for breakfast." 3. "Maybe it's just caused by aging. This usually happens by age 82." 4. "The changes in his behavior came on so quickly. I wasn't sure what was happening."
Which clients may benefit from central venous IV access? Select all that apply
1. The client requiring long-term IV therapy 2. The client receiving caustic IV therapy 3. The client requiring numerous IV infusions that are not compatible and cannot be infused together 4. The unstable client requiring reliable IV access for administration of medications required immediately 5. The client who is afraid of needles and does not want a catheter in the peripheral extremity
The nurse is caring for a 7-year-old girl who is undergoing a stem-cell transplant. Which of the following is a posttransplant intervention?
A) Assessing for petechiae, purpura, bruising, or bleeding B) Limiting blood draws to the minimum volume required C) Administering antiemetics around the clock as ordered D) Monitoring for severe diarrhea and maculopapular rash
Because of their age, children are most likely to gain access to a firearm in:
a. the home or the home of a friend or relative b. a pawn shop c. a local gun dealer or a gun and knife show d. a sports store