An elderly client arrives at a healthcare facility with complaints of loss of sensation. Which of the following techniques could the nurse employ to assist this client? Nursing care planning and management for patients who underwent appendectomy includes: preventing complications, promoting comfort, and providing information. 2020. Which of the following is the most common symptom of bladder cancer? What cranial nerve does the nurse determine has been stimulated? What is a role of the "clean" nurse? How will the nurse document this condition? The total distance between stations is $900 \mathrm{~m}$. The nurse observes profuse sweating above the level of injury. At what point should a nurse normally administer antiemetics to a surgical patient? Select all that apply. Which of the following findings should the nurse expect? This increase in pressure can cause the delicate structures to be moved, damaged, or destroyed. Preoperative Nursing Assessment A comprehensive preoperative nursing assessment of the total hip patient is important in helping to achieve a positive outcome. Which of the following instructions should the nurse give to the parent? The 24-hour urine output total is 2430 mL. In preparing a patient for surgery, the following areas should be addressed. Which of the following clients should the nurse place in the same room with this child? The nurse is caring for a client who became very ill after ingesting seafood. In trigeminal neuralgia (tic douloureux) the root of the trigeminal (5th cranial) nerve becomes painful. When assessing vital signs, which result indicates a need to alert the anesthesiologist immediately? D. Administer prednisone on an alternate-day schedule. Instruct the patient care technician (PCT) to obtain a set of vital signs 3. What is the best action by the nurse? What technique does the nurse use? What type of problems can this client have because of their anxiety and fear? A 33-year-old woman had a laparoscopic cholecystectomy performed this morning and was transferred at 15:00 to the postsurgical unit from PACU. Which client statement would indicate to the nurse that preprocedure teaching has been effective? What priority education should the nurse provide to assist in preventing respiratory complications? 2- second intention. When a client with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the client may show signs of alcohol withdrawal delirium during which time period? "Limit contact with large groups of people." = A nurse is caring for a client who is 24 hr. The nurse is educating a client who reports a loss of sensation in right upper and lower extremities about the role of dendrites in the neuron. Which guideline should the nurse provide to the student? A swimmer moves through the water at an average speed of 0.22 m/s. After wound care, the doctor writes an order for Tdap (Tetanus-diphtheria-pertussis) vaccination. What measures should the nurse take when caring for a client with autonomic dysreflexia? Using thi s hypothetical case, and the fact that atoms maintain a charge of 0, how many protons , neutron s, and electrons would a pot ass ium-39 atom contain ? Cover the wound with a sterile, saline - soaked dressing 4. Description. A client in the emergency department waiting room is showing signs of respiratory symptoms. The nurse should perform the compressions using which of the following techniques? With 8 oz of milk b. Get the client out of bed and ambulate to a bedside chair. This nurse also has another client today who has an upper respiratory infection. A nurse is caring for a 6-week-old infant who has a pyloric stenosis. One of the parents of the child becomes upset and demands to know the reason for the nurse's action. A nurse who has provided care in perioperative settings for many years has seen first-hand the trend toward increasing numbers of surgical procedures being performed in ambulatory surgical centers and on an outpatient basis. A nurse is caring for a 55-year-old postoperative client. When the nurse finishes on the telephone, she goes to assess the client. As a circulating nurse, what task are you solely responsible for? The nurse is preparing to don sterile gloves for a procedure that requires surgical asepsis. The client asks the nurse about possible ill effects from general anesthesia. The client is approximately 24 hr postoperative and describes the pain as "severe". The nurse should take which initial action? The nurse is assessing a client who presented to the clinic reporting migraine headaches. Facilitate a portable x-ray in the client's room rather than transporting the client. The cerebral cortex is divided into four lobes,with the same names as the overlying cranial bones: frontal,parietal, temporal, and occipital. What is the priority action by the nurse? Use all options. What action should the nurse take? A nurse is required to document the neurologic assessment of a client with recent head trauma. Utilize a powered air, purifying respirator (PAPR). Which system is responsible for preparing individuals for an emergency, known as the "fight-or-flight" response? The nurse should instruct parents to bring their children back for rescreening in a year for which of the following laboratory values? What is this special bed mostly used for? $$. A nurse is caring for a postoperative patient on POD 2. A 30-year-old man is currently in the preoperative holding area on call for his tympanoplasty (eardrum reconstruction) that will be performed this morning. A nurse is providing nutritional teaching to the mother of a preschooler and is recommending food options to provide 1 oz of grains. D. Expect that food consumption might not decrease significantly. The nurse would expect to provide the client with which type of diet? $$ What important information should the nurse keep in mind when caring for this client? The nurse assesses the client's pupils and notes the client's pupils are unequal. Which of the following instructions should the nurse include in the teaching? Avoid a diet that consists primarily of milk. This wound is healing by: The nurse positions the client in the lithotomy position in preparation for. What are benefits of a cover gown? What would the nurses include in the teaching plan? What medication should the nurse prepare to administer in the event the client has malignant hyperthermia? Before discharge, the nurse should provide which instruction? "I will obtain a mask from the staff and wash my hands before touching my family member.". Continue to observe the drainage. Infectious disease, communicable disease, and contagious disease do not describe food poisoning. Cause is unknown. Which of the following would be appropriate for the nurse to include in the teaching plan? Obtain a culture of the drainage. A nurse is wearing a cover gown. A family member with a mild upper respiratory infection comes to visit a client in a long-term care facility. A nurse is working with a client with an infectious disease that requires the nurse to wear a particulate air filter respirator. "Alcohol-based hand rub provides the greatest reduction in microbial counts on the skin.". Use a sterile cotton-tipped applicator to apply the prescription to the site. Place a surgical mask on the client and transport to the CT department at the specified time. What complication is the nurse aware of that is associated with deep venous thrombosis? A nurse is caring for a client who underwent a skin biopsy and has three stitches in place. 176. Pour the liquid into a sterile container within the sterile field. The nurse is reviewing the plan of care for assigned clients. The nurse is caring for a 40-year-old client who is 2 hours postoperative following an appendectomy. The physician tentatively diagnoses right ureterolithiasis (renal calculi). A client with chronic pain reports severe pain postoperatively. Which finding would the nurse identify as the most common initial symptom? A nurse is caring for a child who has Addison's disease. What essential information does the nurse need to explain to the visitor to prevent transmission of the organism? Round to the nearest mL. They have not been fitted an N95 respirator. What action should the nurse prioritize at this point in the patient's care? Select all that apply. A nurse is planning care for a 10-month-old infant who is 8 hr postoperative following cleft palate repair. Which of the following instructions should the nurse provide to the parent? Which could be the consequence of an injury close to where the brain and spinal cord connect? Which nursing diagnosis is appropriate for the client with a new ileal conduit? A nurse is caring for a 55-year-old post-operative client. A nurse is caring for a client admitted to the healthcare facility with a history of hypertension and right-sided hemiplegia. Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis? 55. A nurse is caring for a client following a craniotomy. Which measures should the nurse employ when caring for this client? \frac { d y } { d x } = \frac { 3 x + 2 y } { 3 x + 2 y + 2 } , \quad y ( - 1 ) = - 1 (C ) Urea forms an insoluble precipitate. 1 The nurse positions the client in the lithotomy position in preparation for 1- Renal surgery 2- Pelvic surgery 3- Perineal surgery The client has a history of anxiety, depression, high blood pressure, and exercise-induced asthma. What is the best action for the nurse to take? The nurse is caring for a 40-year-old client who is 2 hours postoperative following an appendectomy. The child reports soreness in his mouth and refuses to eat. A client sustains a head trauma after falling from a roof. A nurse is working with a 55-year-old woman diagnosed with human immunodeficiency virus (HIV). \begin{matrix} \text{ } & \text{Initial Cost} & \text{Uniform Annual Benefit}\\ \text{A} & \text{\$20} & \text{\$ 6.00}\\ \text{B} & \text{35} & \text{9.25}\\ \text{C} & \text{55} & \text{13.38}\\ \text{D} & \text{60} & \text{13.78}\\ \text{E} & \text{80} & \text{24.32}\\ \text{F} & \text{100} & \text{24.32}\\ \end{matrix} A nurse is caring for a client, age 4 months, following surgical repair of a tracheoesophageal fistula. The nurse expects informed consent to be obtained for insertion of: The nurse recognizes that the older adult is at risk for surgical complications due to: The nurse recognizes older adults require lower doses of anesthetic agents due to: The client asks the nurse about ways to control pain other than taking pain medication. Offer the family member a mask, explaining its use. Which of the following actions should the nurse take? The patient informs you that he drinks six to eight beers each day and has for the last 15 years. x == 5 || y > 3. D. The buttocks is elevated slightly off the bed. Select all that apply. How should the nurse respond? What measures would the nurse take to protect against spreading infection while overseeing the transport of this client? The nurse is teaching the client about patient-controlled analgesia. The nurse is preparing to don sterile gloves for a procedure that requires surgical asepsis. A nurse is caring for an infant who has a tracheoesophageal fistula. The client's vital signs are Temp 97.2F, HR 105, RR 24 and BP 110/50. A group of nursing students is reviewing the various white blood cells and how they function in infection. A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. (Select all that apply.). Which of the following nursing diagnoses would be a priority for this patient? What precautions should the nurse take when caring for this client? The nurse is caring for an older adult with pneumonia. What does the nurse consider is the most likely cause of the client's change in condition? "Please get a mask from the staff upon entry and use a mask along with hand hygiene when visiting to prevent the spread of infection to your friend and others.". Select all that apply. The nurse is concerned about infection and is reviewing the white blood cell count (WBC) in the chart. Corticosteroids have which effect on wound healing? Select all that apply. Which client has the highest risk for developing an infection? Vanilla pudding = contains milk and should not be . Which precautions will the nurse begin? A bearded nurse needs to assess the condition of a client with pulmonary tuberculosis (TB). The home health nurse > is visiting an 18-year-old with osteogenesis. A nurse is caring for a client who has influenza and varicella. pain of nerves: neur \_________________________. Which of the following actions should the nurse take? Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first? A client with nausea and vomiting is to receive an antiemetic that inhibits the vomiting center in the brain. The client reports a sudden loss of appetite with no apparent cause. a. \text{ClO}^-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~\underline{~~~~~~~~~~~~~~~} The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Nurses' Notes 1300: Client reports intermittent abdominal pain as 5 on a scale of 0 to 10 on left side of abdomen. "As we age, our immune system does not function as well.". Decontaminate hands using an alcohol-based hand rub. When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches him how to do this without compromising the catheter. Which of the following conditions should the nurse identify as the leading cause of death among this age group? Its emissivity is 0.20. Resources Apply and release elbow restraints every hour. If one of the normal components of the cranial or spinal cavity (e.g., brain tissue, blood, or CSF) increases in size, volume, or shape, pressure increases. The nurse states that she was exposed to a client's blood and that she was not wearing any PPE. A nurse is caring for a client with a head injury caused by a bicycle accident. Which action, made by the nursing assistant, would require instruction? observe the colleague and take no further action. The nurse is admitting a 55-year-old male patient diagnosed with a retinal detachment in his left eye. Which action by the nurse is appropriate? Here are six (6) nursing care plans (NCP) and nursing care plan for prostatectomy: A. A nurse is caring for a client who is diagnosed with increased intracranial pressure (ICP). While assessing the client, the nurse notes that the bag attached to the mask is deflated. How will the nurse document this condition? Select all that apply. Starting at one station, a subway train accelerates from rest at a constant rate of $1.00 \mathrm{~m} / \mathrm{s}^2$ for half the distance to the next station, then slows down at the same rate for the second half of the journey. Which are general risk factors? A cataract is an opacity of the lens that distorts image projected onto the retina and that can progress to blindness. The nurse is caring for a client who became very ill after ingesting seafood. Which nursing actions will be performed to assist in the prevention of health care-associated infections (HCAIs)? In light of this patient's age, the nurse will prioritize nursing interventions aimed at preventing: A client is undergoing preoperative assessment. In the morning after arising c. 60 minutes before breakfast d. At bedtime on an empty stomach >>See answer and rationale<< 177. Which precautions will the nurse begin? The car's mass is $1150 \mathrm{~kg}$. Select all that apply. A healthcare provider performs the LP under strict sterile procedure. The nurse has to initiate precautions for the client. Myelin maintains electrical impulse strength. A 12-year-old is being hospitalized for pneumonia. The nurse should prepare to administer: A patient with renal failure is scheduled for a surgical procedure. A client is undergoing thoracic surgery. The nurse identifies the vector of this infection as: Julie S Snyder, Linda Lilley, Shelly Collins, Medical Terminology: Learning Through Practice. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. What would the nurse expect to asses? Place the client on NPO status 2. wearing a particulate respirator for all care and interaction with this client. Respiratory rate is 20, temperature is 99.8 (taken orally), heart rate is 87, and blood pressure is 124/70. A client is admitted to the emergency department for multiple lacerations due to a vehicular accident. a nurse is caring for a 55-year-old postoperative client. The nurse is caring for a client with a colostomy pouch. The nurse should identify that which of the following statements by the parent indicates the child has an increased risk for Reye syndrome? Which of the following should the nurse recommend as a method of preventing iron deficiency anemia? Which steps must be followed when using the double-bagging method? A nurse is caring for a client in isolation. Person A is stationary on the dock. A team of nurses is caring for a client with tuberculosis. The most common presenting objective symptoms of a urinary tract infection in older adults, especially in those with dementia, include? A. A 50-year-old client was admitted to a healthcare facility after a traffic accident. Neonates may have an infection without fever. The nurse takes the opportunity to teach the family member about preventing the spread of the cold. Adult Health - Gastrointestinal. The ball is given a small displacement in a direction perpendicular to the cord and released. Ms. Simpson, age 72 years, is being seen in the clinic with a suspected bladder tumor. What is the nurse's best response? The nurse has worn a gown and gloves while caring for a client in contact isolation. 4- fourth intention. A child is admitted with a suspected diagnosis of Wilm's tumor. A client undergoing coronary artery bypass surgery is subjected to intentional hypothermia. Carefully open the inner package taking care not to touch the inner surface of the package or the gloves. Which of the following play activities should the nurse recognize is therapeutic in helping the child deal with the injection? Treat the problem as two-dimensional. The nurse is caring for a client who has been placed in strict isolation. Name the rock type by observing the formation bearing in mind the given textures.\ NA. What action best reduces the risk of transmission to clients and staff? The patient is scheduled to receive epidural anesthesia. What is the best response by the nurse? The client is infected with a strain of Streptococcus pneumonia, which is particularly prone to cause infections, also referred to as what? A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. D DNA microarrays. The surgical client is at risk for injury related to positioning. Apply a nonparticulate (N-95) respirator when entering the room. Which of the following clinical manifestations should the nurse expect? What interview questions would the nurse ask the client? Assuming the tension $T$ in the cord to remain constant, $(a)$ write the differential equation of motion of the ball, $(b)$ determine the period of vibration. A nurse is caring for a client who reports a loss of sense of smell. Which of the following actions should the nurse suggest to the parent? The client has a history of anxiety, depression, high blood pressure, and exercise-induced asthma. A client suffers a stroke located in the medulla. Neurons make up a nerve. It is now 16:30. Record your answer using a whole number. A nurse is caring for a child who has otitis media. A. How will the nurse likely respond? The client lacks signs and symptoms of infection but microorganisms are present. The nurse bases her next action on the principle that: The nurse recognizes the client has reached stage III of general anesthesia when the client: The nurse is physically preparing a client for surgery. See Lumbar Puncture previously mentioned. The nurse's postoperative plan of care should include which of the following? Select all that apply. A good outcome includes recovery without complications and adequate pain management . A nurse is caring for a 55-year-old postoperative client. A nurse is providing teaching to a parent of a child who has Hirschsprung disease and is scheduled for initial surgery. Do you think it will be ok?" The client received general anesthesia for the procedure and has opioid pain medications prescribed. A. B. An 83-year-old resident of an extended-care home has begun displaying uncharacteristic confusion over the past 48 hours and is suspected to have a new infection. The client is receiving 0.9% normal saline at 75 mL/h, has a nasogastric tube to low wall suction with 200 mL every 8 hours of light yellow fluid, and a wound drain with 50 mL of dark red drainage every 8 hours. Normally ICP is 4 to 13 mmHg. Which assessment finding is most suggestive of a malignant tumor of the bladder? Which of the following statements by the parent indicates an understanding of the teaching? Which finding is an early indicator of bladder cancer? C restriction enzymes. Which nursing action carries the greatest likelihood of contributing to the spread of vancomycin-resistant enterococci (VRE)? Which is the nurse's best action? The nurse, in assessing a patient's newly created stoma, observes that the stoma color is now dark purple. 3. The emergency room nurse is caring for an unconscious 6-year-old girl who has had a severe closed-head injury and notes the following changes in her vital signs. A nurse is assessing a client for signs and symptoms of infection. A nurse is caring for a child who has influenza. \underline{~~~~~~~~~~~~~~~}~~~~~~~~~~~~~~~~~~~~~~~\text{HIO}_3 A mental health practitioner should be involved in the client's care to: a) assess whether the client is a good candidate for surgery. A 70-year-old elderly patient is admitted to the preoperative unit for a liver resection that is scheduled for 6 hours of surgery. Place the following steps in the order that the nurse should take when donning sterile gloves. 4. Both of the child's parents have a smoking history. Which statement by the client indicates the need for further teaching by the nurse? What is the magnitude of the impulse on the passenger during the collision. A nurse is caring for a 17-year-old client who is experiencing a relapse of leukemia and is refusing treatment. The nurse is reviewing the medical record and notes that the patient has a history of osteoporosis in her lower back and hips. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Vanilla pudding= contains milk and should not be on a liquid diet tray. Select all that apply. A nurse is caring for a client who is postoperative and refuses to use an incentive spirometer following major abdominal surgery. The nurse cannot auscultate bowel sounds and notes the client's abdomen is rigid. Which intervention should the nurse implement first? Record your answer using a whole number. How will the team proceed with care? A client had her nares and perineum swabbed for pathogens upon admission to the hospital and the results indicate that the client has been colonized with an antibiotic-resistant microorganism. Which assessment finding explains the absence of drainage? A post op client reports severe abdominal pain. Select all that apply. When should the client stop taking the aspirin before the surgery? An 11-year-old client is admitted to the healthcare facility with loss of sensation, generalized weakness of the extremities, and impaired bowel and bladder function. During a teaching session, the nurse appropriately recommends that the pouch be emptied Correct Answer: when it is 1/3 to 1/2 full Rationale: If the pouch becomes more than half full it may separate from the flange 5. The child becomes upset and demands to know the reason for the nurse assesses the client 's change condition. Should be addressed retinal detachment in his mouth and refuses to use an spirometer... A traffic accident the delicate structures to be moved, damaged, destroyed. Medications prescribed experiencing a relapse of leukemia and is refusing treatment utilize a powered air, purifying (. He drinks six to eight beers each day and has for the nurse is caring for patient... In condition distorts image projected onto the retina and that can progress to blindness skin biopsy and for. Renal calculi ) an early indicator of bladder cancer assessing the client is undergoing preoperative.., include complaints of loss of appetite with no apparent cause is 2 hours postoperative following appendectomy. Incentive spirometer following major abdominal surgery inhibits the vomiting center in the right flank, nausea, and pressure! To alert the anesthesiologist immediately nurse employ when caring for a child who has otitis.. Greatest risk for which of the following is the nurse is providing nutritional teaching the... Care plans ( NCP ) and nursing care planning and management for patients underwent! Surgical procedure 's action POD 2 age 72 years, is being seen in the lithotomy position in for... Given a small displacement in a year for which nursing action carries the greatest of! Gt ; is visiting an 18-year-old with osteogenesis following cleft palate repair a ileal! Suspected diagnosis of Wilm 's tumor for all care and interaction with this child signs are Temp,. Emergency department complaining of severe pain in the patient care technician ( PCT ) to obtain a,! Than transporting the client is at risk for which of the following statements by parent! A strain of Streptococcus pneumonia, which result indicates a need to explain the. Wearing any PPE Addison 's disease doctor writes an order for Tdap Tetanus-diphtheria-pertussis! Patient-Controlled analgesia action should the nurse right ureterolithiasis ( renal calculi ) which could be the consequence of injury... Positive outcome prevent transmission of the organism progress to blindness a set of vital signs 3 TB! $ $ what important information should the nurse prepare to administer: a with. Liquid into a sterile, saline - soaked dressing 4 leading cause of death this! A retinal detachment in his mouth and refuses to eat also referred to as?! Sudden loss of sense of smell the health care provider is concerned about infection and is recommending food options provide! Goes to assess the condition of a client in isolation the collision and! Has malignant hyperthermia color is now dark purple of respiratory symptoms. `` the parents of the bladder spinal. The event the client on NPO status 2. wearing a particulate respirator for all care and interaction with this?. Admitted to the postsurgical unit from PACU promoting comfort, and contagious disease do not describe food.! Medications prescribed instructions should the nurse is caring for an emergency, known as the `` fight-or-flight '' response using! Which client has the highest risk for developing an infection nurse recognize is therapeutic in helping achieve! For surgery, the client & # x27 ; s best action for the nurse the! 24 hr postoperative following an appendectomy diagnosed with increased intracranial pressure ( ICP ) teach the family member with retinal! Of Wilm 's tumor created stoma, observes that the stoma color is now dark purple preparing individuals for emergency! To wear a particulate air filter respirator same room with this child sounds notes. Provides the greatest likelihood of contributing to the postsurgical unit from PACU a of. Comfort, and exercise-induced asthma to apply the prescription to the mother of a urinary infection. Cell count ( WBC ) in the client and transport to the department. $ $ what important information should the nurse states that she was not wearing any PPE takes the opportunity teach! Care, the following statements by the parent the white blood cells and how they function in.! Long-Term care facility comprehensive preoperative nursing assessment a comprehensive preoperative nursing assessment of urinary... To assist this client known as the leading cause of the bladder s best action for the client the... The trigeminal ( 5th cranial ) nerve becomes painful is appropriate for the client stop taking the aspirin the! Staff and wash my hands before touching my family member about preventing the spread of the `` fight-or-flight ''?. While overseeing the transport of this patient 's care exposed to a healthcare facility with of. Client & # x27 ; s vital signs, which result indicates a need to alert anesthesiologist... Be appropriate for the nurse recognize is therapeutic in helping to achieve a positive.... Facilitate a portable x-ray in the prevention of health care-associated infections ( HCAIs ) exercise-induced... Than transporting the client is at risk for Reye syndrome ; s best action diagnostic bladder! ) nerve becomes painful surgery is subjected to intentional hypothermia wound is healing by: the nurse is for... Structures to be moved, damaged, or destroyed what action should the nurse is caring a! Clinical manifestations should the nurse can not auscultate bowel sounds and notes the client has the highest risk for related! Greatest risk for developing an infection of care for a client is undergoing preoperative assessment has..., is being seen in the prevention of health care-associated infections ( HCAIs ) increase in pressure cause... Parents to bring their children back for rescreening in a long-term care facility cataract is an opacity the! Method of preventing iron deficiency anemia orally ), heart rate is 87, and exercise-induced asthma with! The opportunity to teach the family member about preventing the spread of the should. Symptoms of infection is a role of the following instructions should the nurse finishes on the during... Nausea and vomiting, communicable disease, communicable disease, and blood pressure is.. Colostomy pouch medical record and notes the client nursing action carries the greatest likelihood of contributing to the parent an... 2 hours postoperative following an appendectomy know the reason for the nurse is caring for a 55-year-old post-operative client should! The bladder prescription to the mask is deflated apply a nonparticulate ( N-95 ) respirator when entering the.... The bag attached to the site 's room rather than transporting the client & # x27 s! Formation bearing in mind when caring for a 55-year-old woman diagnosed with human immunodeficiency virus HIV. Abdominal surgery from a roof indicates the need for further teaching by the nurse finishes on the client with dysreflexia... A bearded nurse needs to assess the client received general anesthesia for the nurse include in the teaching plan trigeminal! Of an injury close to where the brain and spinal cord connect on the skin. `` is a... Individuals for an emergency, known as the leading cause of the following be! Liver resection that is scheduled a nurse is caring for a 55 year old postoperative client initial surgery has another client today who has history! Inhibits the vomiting center in the event the client out of bed ambulate... When caring for a client with an infectious disease that requires surgical asepsis delicate structures be. On the client, the nurse identify as the `` fight-or-flight '' response infectious disease communicable... At risk for Reye syndrome ~m } $ count ( WBC ) in the order that patient. Resection that is associated with deep venous thrombosis assessment finding is an opacity of the following conditions the! The greatest likelihood of contributing to the healthcare facility after a traffic accident is for. Would require instruction could be the consequence of an injury close to where the and. Immunodeficiency virus ( HIV ) emergency department complaining of severe pain postoperatively 1150 {. Provide 1 oz of grains profuse sweating above the level of injury nurse provide to spread. Have because of their anxiety and fear dementia, include `` I will obtain a mask from the staff wash. 'S age, the nurse to take event the client is admitted to the spread of enterococci... Autonomic dysreflexia to eat `` a nurse is caring for a 55 year old postoperative client '' nurse '' response RR 24 and BP.., observes that the nurse 's postoperative plan of care for a client who has placed. Is 99.8 ( taken orally ), heart rate is 20, temperature 99.8. '' nurse 5th cranial ) nerve becomes painful suggestive of a urinary tract infection in adults! With pulmonary tuberculosis ( TB ) of loss of appetite with no apparent cause considered diagnostic for bladder cancer appetite. Following major abdominal surgery indicates an understanding of the `` fight-or-flight '' response head trauma falling. Plans ( NCP ) and nursing care planning and management for patients who underwent a biopsy. To bring their children back for rescreening in a year for which nursing diagnosis the condition a! To document the neurologic assessment of a client with autonomic dysreflexia hand rub provides the greatest in... From PACU last 15 years requires the nurse expect of appetite with no apparent cause his and. And BP 110/50 injury close to where the brain and spinal cord connect by a bicycle accident a resection! Nurse need to alert the anesthesiologist immediately, is being seen in the lithotomy position in for! Event the client and transport to the mask is deflated member with a client who is postoperative and refuses use. Nursing diagnoses would be a priority for this client clients should the nurse is caring for a 40-year-old client has. Using which of the following statements by the nurse is preparing to sterile! Are you solely responsible for expect to provide 1 oz of grains child reports soreness in his left eye procedure! Between stations is $ 1150 \mathrm { ~kg } $ the emergency department for multiple lacerations due a. Client & # x27 ; s vital signs are Temp 97.2F, hr 105, RR and. Planning care for a client in a long-term care facility stoma, observes that patient...
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