The nurse is reviewing morning labs for a client. Which lab value requires immediate intervention by the nurse?
calcium 9.8 mg/dL sodium 137 mEq/L chloride 104 mEq/L potassium 3.1 mEq/L
Category: Physiological Adaptation
The nurse is caring for a client with a Braden score of 13. How does the nurse interpret this client’s risk of skin breakdown?
high risk mild risk severe risk moderate risk
The nurse is caring for a client with cardiogenic shock. The nurse expects which signs present with this client? Select all that apply.
hypertension; slow, labored breathing decreased urine output; warm, pink skin increased urine output; cool, clammy skin hypotension; weak pulse; cool, clammy sk...
The nurse is caring for a client who has been diagnosed with pulseless electrical activity (PEA). Following effective CPR and administration of epinephrine, which is the next priority nursing action?
check for a pulse insert a urinary catheter prepare to shock the client administer a bolus of sodium bicarbonate
The nurse is caring for a client with abdominal aortic aneurysm. Which observation by the nurse indicates the need for immediate intervention?
complaints of yellow-tinted vision sudden onset of frothy, pink sputum urinary output of 75 mL/hr. per urinary catheter complaints of sudden and severe back pai...
The nurse is caring for a client who presents to the ED with the following arterial blood gas (ABG) results:
The nurse is caring for a client who presents to the ED with the following arterial blood gas (ABG) results: pH 7.32 PaCO2 47 mm Hg HCO3 24 mEq/L PaO2 91 mm Hg ...
The nurse is caring for a client at risk for postpartum hemorrhage. Which early sign of hemorrhage should the nurse monitor for this client?
coma hypotension restlessness cool, clammy skin
The nurse is caring for a 9-year-old boy who presented to the ED after a penetrating injury from a BB gun. The client is diagnosed with a hyphema. The nurse proceeds to place the client in which position?
flat in bed semi-Fowler’s Trendelenburg’s lateral on the unaffected side