“Aspirin can be used for mild pain when you have a flare-up.” “Avoid foods high in purines such as organ meats and shellfish.” “Lasix can help keep your urine flushed out to lessen the chance of an attack.” “A few glasses of wine every week will help you reduce stress, which can trigger an attack.”
The nurse is caring for a client who just had a bone marrow biopsy. The nurse understands that which statement is the nursing priority for this client?
keeping the client NPO for 2 hours avoiding contact sports for 24 hours monitoring the client for excessive bleeding applying alcohol to the site every 4 hours to prevent infection
The nurse is teaching a newly diagnosed client about Guillain-Barre syndrome (GBS). What information would the nurse provide in her teaching? Select all that apply.
GBS affects females more often than males. The acute period lasts several days to 2 weeks. GBS tends to be self-limiting with temporary paralysis. Common symptoms include muscle weakness and paralysis. Infections such as Epstein-Barr virus have been associated with GBS.
The nurse is reviewing labs on a client with second- and third-degree burns from a house fire. Which abnormal lab value would the nurse expect to find with this client?
pH of 7.41 albumin of 3.9 g/dL hemoglobin of 15 g/dL potassium of 5.9 mEq/L
The nurse is preparing to extubate a client. Arrange in order of priority the actions that the nurse should take to perform this procedure.
hyperoxygenate the client explain the procedure to the client immediately instruct the client to cough apply oxygen by nasal cannula or face mask thoroughly suction the ET tube and the oral cavity teach the client how to use an incentive spirometer every 2 hours rapidly deflate the ET tube cuff and remove tube at peak…
The nurse is caring for a client with dementia who has pulled out three peripheral IVs. Which intervention by the nurse is the best way to manage this client?
place the client in restraints or mitts tell the family that they need to stay with the client replace the IV and wrap it in gauze to hide it from view tell the client that if she pulls another IV out, she will have to have a PICC line placed
Mix and Match: Match the laboratory test to the abnormal value.
Laboratory Test Abnormal Value calcium 8.1 mg/L pH 7.56 specific gravity 1.000 potassium 5.8 LDL 160 mg/dL HDL 34 mg/dL
The nurse is caring for a client who was admitted with an upper respiratory infection. The client’s temperature is 102.4°F, and he is confused. In the last 2 hours, systolic blood pressure has dropped from 138 to 90. The nurse should perform which intervention?
obtain blood cultures place the client on NPO status administer supplemental oxygen administer antipyretics as ordered encourage rest and limit physical activity provide a warming blanket to alleviate chills
The nurse is caring for a client who is undergoing a pharmacological stress test because she cannot use the treadmill. The nurse administers the prescribed dose of adenosine. Which physiological response indicates an adverse effect of the adenosine requiring intervention by the nurse?
nausea RR of 18 HR of 97 chest pain facial flushing
The nurse is caring for a client who just had an arteriovenous (AV) fistula placed for dialysis. The nurse is providing home care instructions to the client. Which statement by the client indicates a need for further teaching by the nurse?
“I should avoid wearing a watch on my arm with the fistula.” “It may take several weeks before the fistula is ready to use.” “I should not have my blood pressure taken in my access arm.” “I should wear tight sleeves to protect and support the fistula so I don’t bend it.”