itchy skin nausea pale stools colorless urine none; this is a normal lab value
The nurse is reviewing labs of a newly admitted client. Which lab result would prompt the nurse to contact the health care provider?
ALT 33 units/L BNP 760 pg/mL WBC 10,450 mcL direct bilirubin 0.2 mg/dL
The nurse is assisting the health care provider to perform a renal biopsy. Which position should the nurse place the client in?
in the semi-Fowler’s position on the same side of the kidney to be biopsied on the side opposite of the kidney to be biopsied prone with a pillow under the shoulders and abdomen
The nurse is caring for a client receiving hemodialysis. During hemodialysis, the client becomes anxious, experiencing tachypnea and hypotension. The nurse suspects which complication of hemodialysis?
air embolism clotting of the graft site dialysis encephalopathy disequilibrium syndrome
The nurse is caring for a client who has a lithium level of 2.2 mEq/L. Based on this lab value, what would the nurse anticipate to do in order to care for this client?
prepare to administer IV fluids notify the health care provider order a mechanical soft diet for the client administer the next dose of lithium when it is due observe the client for confusion and slurred speech
The nurse is caring for a client who just arrived in the PACU following a colonoscopy with polyp removal. The client’s level of sedation is assessed using the Ramsay Sedation Scale (RSS). The client responds quickly, but only to commands. What Ramsay score would the nurse chart for this client?
RSS 1 RSS 2 RSS 3 RSS 4 RSS 5 RSS 6
The nurse is evaluating clients for risk of heparin-induced thrombocytopenia (HIT). Which client is at greatest risk for HIT, based on the nurse’s assessment?
a male client who just completed a 1-week course of heparin a male client taking enoxaparin for management of unstable angina a female client receiving heparin for postsurgical thromboprophylaxis a female client taking enoxaparin to prevent clots following a mild myocardial infarction
A 2-month-old infant has been brought to the ED. Which finding by the nurse would raise suspicion for shaken baby syndrome?
failure to track with the eyes crying without tear production bruising to the arms and shoulders greater-than-expected head circumference and bulging fontanels
The nurse is teaching a group of student nurses about radiation therapy. Which would the nurse include in the teaching?
The dose is always more than the exposure. Clients receiving brachytherapy are radioactive. Clients receiving teletherapy are not radioactive. Beta particles are the most common type of radiation therapy. Bodily waste from a client receiving brachytherapy does not require special handling.
The nurse is caring for a client in the cardiac unit and notices the client’s rhythm changes from normal sinus rhythm to coarse ventricular fibrillation. Which is the priority nursing action?
call a code blue check the client and check the leads initiate CPR while waiting on help to arrive prepare to start the client on a diltiazem (Cardizem) drip clear the room of unnecessary items to allow room for the crash cart and team