he nurse is taking the blood pressure measurement of a client with Parkinson's disease. Which information in the client's admission assessment is relevant to the nurse's plan for taking the blood pressure reading? (Select all that apply). Frequent syncope Occasional nocturia Flat affect Blurred vision Frequent drooling
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The nurse is taking the blood pressure measurement of a client with Parkinson's disease. Which information in the client's admission assessment is relevant to the nurse's plan for taking the blood pressure reading? (Select all that apply).
- Frequent syncope
- Occasional nocturia
- Flat affect
- Blurred vision
- Frequent drooling
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- What activities will the nurse tell the client to avoid after cataract surgery? (Select all that apply.) Sleeping for greater than 1 hour Lifting items greater than 10 pounds Blowing one's nose Bearing down when one defecates UrinatingSally asks the nurse if she can have her next dosage of pain medication. The best next action by the nurse is to: Sally Smith has her surgery to place stents without complications and returns to her room after a brief observation in the post-anesthesia care unit and continues to receive morphine 5 mg q6h for pain. Her last dose was at 2200. At 0400, the nurse takes the following vital signs and documents them in the electronic medical record (EMR): VITAL SIGNS Normal Range 0905 0400 Temperature 97.8°F - 99.1°F (36.5°C - 37.3°C) 37°C (98.6°F) 37°C (98.6°F) Heart Rate 60-100 beats per minute 96 beats per minute 92 beats per minute Respiratory Rate 12 to 20 breaths per minute 16 breaths per minute 11 breaths per minute (Low) Blood Pressure 90/60 mm Hg to 120/80 mm Hg 120/72 mmHg 108/62 mmHg Oxygenation 95%-100 % 98% on room air 98% on room air Pain 0/10 7/10 (High) 6/10 (High) Sally asks the nurse…The nurse is completing the admission assessment of a 3-year-old who is admitted with bacterial meningitis and hydrocephalus. Which assessment finding is evidence that the child experiencing increased intracranial pressure (ICP). Blood pressure fluctuation and syncope Sluggish and unequal pupillary responses Tachycardia and tachypnea Increased head circumference bulging fontanels
- A medication order reads: “Hydromorphone, 2 mg IV every 3to 4 hours PRN pain.” The prefilled cartridge is available witha label reading “Hydromorphone 2 mg/1 mL.” The cartridgecontains 1.2 mL of hydromorphone. Which nursing action iscorrect?a. Give all the medication in the cartridge because itexpanded when it was mixed.b. Call the pharmacy and request the proper dose.c. Refuse to give the medication.d. Dispose of 0.2 mL correctly before administering the drug.The surgeon has prescribed 5/150 mg hydrocodone bitartrate and acetaminophen PO Q6H prn pain. The nurse is reviewing the drug label and preparing to administer the opioid to the client who is complaining of 8 out of 10 RUQ pain. What pain scale was used to assess this client? How many tablet(s) will the nurse administer per dose? (Be sure to include units.) What is meant by 300 mg on the drug label below? If the nurse administers the first dose at 1730 to the client, when can the client have the next dose? What type of order is prn?Ms. Hall has an order for hydromorphone (Dilaudid), 2 mg,intravenously, q 4 hours PRN pain. The nurse notes thataccording to Ms. Hall’s chart, she is allergic to Dilaudid. Theorder for medication was signed by Dr. Long. What would bethe correct procedure for the nurse to follow in this situation?a. Administer the medication; the doctor is responsible formedication administration.b. Call Dr. Long and ask that she change the medication.c. Ask the supervisor to administer the medication.d. Ask the pharmacist to provide a medication to take theplace of Dilaudid.
- A nurse is preparing a patient for a cesarean section and teachesher the effects of the regional anesthesia she will be receiving.Which effects would the nurse expect? Select all that apply.a. Loss of consciousnessb. Relaxation of skeletal musclesc. Reduction or loss of reflex actiond. Localized loss of sensatione. Prolonged pain relief after other anesthesia wears offf. Infiltrates the underlying tissues in an operative areaThe nurse is administering an intra-enous dose of morphine sulfate to a 48-year-old postoperative patient. The dose ordered is 3 mg e-ery 3 hours as needed for pain. The medication is supplied in -ials of 4 mg/mL. How much will be drawn into the syringe for this dose?Under which condition would the nurse cut away all the client's clothing? Select all that apply. One, some, or all responses may be correct. When cervical spine protection is needed If client is suffering from a simple fracture If fabric may fuse to the client's skin because of burns If rapid access to the client's body is critical for resuscitation When needing access to a particular body part during an emergent situation
- The nurse will administer Phenytoin (Dilantin) per IV to the client with grand mal seizures. Which of the following should the nurse prepare? 10mL LR 10 mL NaCl 0.9% 10mL D10WDr. Falcone is an emergency department physician who has just called the OR desk concerning a patient he tells the charge nurse we have a 23-year-old male patient status post MVA a no airbag deploy moderate facial injuries bruising and swelling about the left eye diplopia and enophthalmos city confirmed left orbital floor fracture you'll be up in 10 minutes what does MVA stand forThe nurse is practicing the therapeutic communication technique of broad opening. Which of thefollowing statements by the nurse best demonstrates a correct understanding of this technique?a. “How do you feel when you are arguing with your daughter?”b. “What are you thinking about?”c. “Are you planning on hurting yourself?”d. “You are biting your fingernails. Is something bothering you?”