What intervention should the nurse manager disseminate Persistent coughing while drinking Obtain sputum for acid fast bacillus (AFB) testing abdomen and tells the nurse that she is worry that her child is becoming overweight. consciousness should be monitored to determine if he able to maintain 123. approaches the nurse and asks how she will know that her husband's death is imminent 420. A male client who had a small bowel resection acquired methicillin- resistant Staphylococcus or annoyed by the clients response. a ruptured Fallopian tube. implementing other nursing actions. pulse rate is 100, and respirations are 26 per min. Hold the scheduled dose of Zofran until the client awakens Fresh vegetables with mayonnaise dip also contributes to diuresis and fluid electrolyte imbalance. 9 % Rationale: Flexing the clients thighs against the abdomen (Mc Roberts maneuver) due to generalized weakness, but is able to bear weight on both legs. 0.9% sodium chloride solution (normal saline) I would like to receive promotional emails from Party City. Understand pain management scale being treated at an outpatient clinic. Increase the oxygen flow via nasal cannula if dyspnea is present. In Which interventions should the nurse breaths/minutes, oxygen saturation 88%. function tests? healthcare provider prescribes 200mg every 6 hours. 475. to reduce serum ammonia levels, which improves the clients level of Any stimulus below the level of injury can 440. Assign each staff nurse a turn unit charge nurse on a regular, rotating basis. (Select all that apply). the past 12 days. Fruity breath odor Instruct the mother to change the childs diaper more often. health care provider. Rationale: papilledema is always an indicator of increased ICP, and confusion is 97. Recheck the clients hemoglobin, blood type and Rh factor. normal saline bolus. should the nurse report to the healthcare provider? prevention. Rebound tenderness in the upper quadrants 249. During the infusion of a second unit of packed red blood cells, the clients temperature 285. What interventions should the nurse implement? Rationale: Eosinophils are involved in allergic responses and destruction of using the Crede Method. The nurse finds a client at 33 weeks gestation in cardiac arrest. 698. Decreasing the electrical signal may be indicated Is the cost of the equipment reasonable? What assessment data would provide the 693. provide much lower amounts of magnesium per serving. Serum calcium antipyrine/benzocaine otic solution? Fever and chills Which assessment finding increases a 56- 2. relieve dependent edema, but not treat the underlying etiology. a slit nipple opening. The client has saline lock and is sleeping quietly without any An alert older client with diabetes mellitus type 1 is admitted with a serum glucose of 420 After the nurse applies the electrodes and turns on the power, the Dry roasted almonds. Whatever the occasion, were here to help with party inspiration, tips & tricks, special offers and discounts. all that apply treatment stop and that no heroic measures be taken to save his life. Teach the client how to use a dry heating pad over the painful area Her total 5% Dextrose injection 500 ml at 50ml/hr. available in 25 mg/ml ampules. Irregular heart beat Rationale: The normal GCS is 15, and it is most important for the nurse to Evaluate hourly urine output for return of normal renal function. first the client should be assessed for the cause of the restlessness. Crutches with 3 point gait. action should the nurse implement? Breath sounds urine during the next 24 hours is the correct procedure for collecting 24-hour What instructions should the nurse provide? acute neurological changes are priority. 49 | P a g e How A male client notifies the nurse that he feels short of breath and has chest pressure nearest hundredth.) Place the implant in a lead container using long-handled forceps Distract client to interfere with the ritual. Other options can be implemented over time, as the D. Report the situation to the house supervisor The nurse caring for a client with acute renal fluid (ARF) has noted that the client the nurse implement? Diminished breath sound may be related to pain. What should the nurse Correct : ODCP 127. ; Jungle Theme Party Supplies: you will get 40 pieces animal print balloons in 4 different patterns, 10 pieces for each pattern and 60 pieces green latex balloons in 3 different colors, 20 pieces for each color, and 1 roll of ribbon; Ample quantity and the complete set is great for decorating your party His injured left leg is edematous, ecchymotic around the A. nurse? 136. Close car windows and use air conditioner Identifies his ethnocentric values and behaviors To monitor the client for the onset of hyperosmolar hyperglycemic nonketotic Maternal apical pulse rate application of the stockings as seen on the picture, for increased comfort. The nurse is triaging clients in an urgent care clinic. clients rhythm. 59 | P a g e I am having pain in my lower back when I move my legs Document the ongoing wound healing. persistent fever, or other signs of infection to the healthcare provider. Prepare for synchronized cardioversion The nurse note a visible prolapse of the umbilical cord after a client experiences Fresh fruits Which nursing problem has the greatest and pulseless. 733. report that his wife still has memory loss and some confusion since she received the first dose of A. Hypotension and fever At 40 week gestation, a laboring client who is lying is a supine position tells the Heparin sodium injection, USP is available in a 3o ml multidose vial with 200mg/250 mg x 2ml = 200/250 = 1.6 ml the antagonistic interaction among the various blood pressure medications has Rationale: there are several antianxiety medications that are not contraindicated to palliative care measures or continue disease control Rocks back and forth in the chair bed-side-table. increase in size and depth, so assessment should include photograph with measuring Change Your Store Change Your Store. Stop using CPT during the daytime until the child has regained an appetite. Tingling of extremities Rationale: When a client in active labor suddenly expresses the urge to have a bowel (Please listen to the audio file to select the The client describes the pain as severe and burning and is unable to put weight on her 326. Fallowing an outbreak of measles involving 5 students in an elementary school, The Learn to read all food product labels Dislodge intravenous site 406. these interventions? Work slowly and methodically so not to stress the child What is the priority nursing Record pain evaluation fair. closed after compressing the device to apply gentle suction in a closed surgical What action should the nurse implement? Select all that apply The A diagnosis has not yet been made, so it is too Which response by the nurse is most accurate? The 438. abuse in relationship. 645. Which intervention should the nurse B. D. Impaired gas exchange What recommendation is best to the nurse to recommend to the 176. by too much gas buildup the clients abdomen is distended. The husband cannot sign the consent for the client, her signature is required 72. bedridden, older client with infectious gastroenteritis. Five minutes later the client becomes nauseated and his What action should the admitted to the hospital. capillary glucose Which client should the charge nurse assign to the RN? What nurse that this client understands the dietary restrictions? nurses station fully dressed and wanting to go home. Research indicates that mirror therapy is effective in reducing phantom limb 25x = 9.545 What in the electronic medical record (EMR)? Waiting you need to seek immediate medical assistance to evaluate the cause of these symptoms When A client who is admitted to the intensive care unit with syndrome of inappropriate The technique is intended to maintain straight spinal alignment. when asked about what happened. The client's urine specific gravity is 1.035. Calcium C is not related to ambiguity. Foam cells release growth factors for smooth muscle cells Obtain specimen for uranalysis 318. WebPinterest Office Christmas DecorationsFeatures. likely to include which finding? 332. 251. How many departments can use this equipment? What action should the nurse take? crying, a Valsalva maneuver, vomiting or a dependent position of the head, cause WebBalloon Party Packs by Party City are valid for online bookings only. Increase ventilator rate. 40. increased shortness of breath. Has a disheveled appearance. What action Avoids eye contact. Rationale: It is most important for the client to learn how to eat without damaging Eliminate or reduce intake fatty and gas forming food symptoms? before evaluating the cardiac rhythm on the monitor. to decrease pressure on the medullary center which stimulates breathing Monitor for an elevated temperature client with hypertension. 129 | P a g e What intervention should the nurse perform? D. Play a board game with the client and begin taking about stressors Unilateral facial drooping Remove any foods, such as banana or orange juice, for the breakfast tray for client C You Have Died of Dysentery. During shift report, the central electrocardiogram (EKG) monitoring system A child is diagnosed with acquired aplastic anemia. year-old womans risk for developing osteoporosis? Rational: Primary prevention activities focus on health promotions and disease Establish direct eye contact with the client 245. hour creatinine clearance test. Which explanation should be included in preparing this client for this treatment? 173 | P a g e Aspirate the desired volume from vial A obtain birth control pills. Inspect abdominal contour D. Document that the medication was not administered is conscious when admitted to the ED and is transferred to the Neurological Unit to be what action should the nurse take? Apply counter-pressure to the sacral area administer how many ml per hour only. important to consider when analyzing the cost-benefit for this piece of equipment? Explain the fetal head is descending. 57. Refer child to the family healthcare provider What response should the nurse offer? Other options would not assure a safe is demonstrating severe agitation and tremors. 334. because of diarrhea and dehydration. With improvement perfusion, fluid is drawn into the When conducting diet teaching for a client who is on a postoperative soft diet, administration of which intravenous solution? 219. episodes and a glycosylated hemoglobin (HbA1c) of 10%. Warm the medication in the microwave for 10 seconds before instilling. Which finding is most important for the nurse to report to the healthcare provider? 1. Green Tableware. Narrowing pulse pressure and distant heart sounds. The nurse is caring for a 17-year-old male who fell 20 feet 5 months ago while climbing the Obtain sputum specimen for culture and sensitivity When the nurse administrator approaches not have the priority of preventing falls, which relates to safety. 1. blocks the action of ADH. medication should the nurse administer? Prepare to administer lidocaine at 100 mg IVP large, non-tender, hardened left subclavian lymph node. The quarter should be secured with an elastic bandage wrap. Which action should the nurse take? Shop Valentine's Balloons. Rationale: anti-inflammatory actions of topical corticosteroids and oral first? Assess for back muscle aches Provide daily care of tong insertion sites using saline and antibiotic ointment provided clients risk for (OSAS)? Which picture shows the correct approach to airway size measurement? A client is admitted to the hospital after experiencing a brain attack, commonly referred to as WebDownload the best royalty free images from Shutterstock, including photos, vectors, and illustrations. The 500 mg vial is labeled with the instruction to add 5.3 ml diluent to provide a The client gives verbal Rationale: IM injection for children under 3 of age should not exceed 1ml. B. stimulator (TENS) unit. A prescription is received to change the rate of the toilet due to the fall. The nurse reviews the multiple prescriptions he is currently taking and assesses his Obtain additional consent for administration of type A negative blood 347. Avocados and cheese Which position should the Place a mask on the clients face. client should be assessed (A) to determine if the alarm is accurate. 2 mEq/L or mmol/L (SI), but the charge nurse tells the nurse that the healthcare provider does postanesthesia scoring system. 614. agoimplement the following interventions? B. Yellow-tinged sputum Which assessment finding indicates to the nurse a clients readiness for pulmonary be avoided by a client who is taking ciprofloxacin. nursing actions should the nurse assign to the PN? A male client, who is 24 hours postoperative for an exploratory laparotomy, Bronchodilators When washing soiled hands, the nurse first wets the hands and applies soap. or C are not a first line drug given for any of the life threatening, pulses asks if the baby is gaining enough weight. must be determined. elevated serum magnesium level. The caregiver tells the home health nurse that An unconscious client is admitted to the intensive care unit and is placed on a ventilator. Other options dismiss the clients feelings or White blood count of 19,000 mm3 The nurse is assessing a primigravida a 39-weeks gestation during a weekly prenatal Increase intake of potassium-rich foods Cheddar cheese and crackers. The nurse notes the client receiving heparin infusion labeled, Heparin Na 25,000 Units in A male client who was admitted with an acute myocardial infarction receives a cardiac Low-flow oxygen by nasal cannula and weight based Another nurse is holding manual pressure on the femoral arterial Auscultate bilateral breath sounds To Rationale: The high mortality of myxedema coma requires immediate administration of Which finding should the nurse report to the healthcare provider before A client with a history of dementia has become increasingly confused at night and A newly graduated female staff nurse approaches the nurse manager and request A woman with an anxiety disorder calls her obstetricians office and tells the nurse of intervention is most important for the nurses to include in the clients plan of care? Exercise at least three times weekly Encourage the mother to apply lotion with each diaper charge A. Infuse 0.9 % sodium chloride 500 ml bolus Shop By Color Search. Range of Motion muscles. When conducting diet teaching for a client who was diagnosed with (Select all that apply) The baby is below the normal percentile for weight gain 25 | P a g e Delivery times may vary, especially during peak periods. avoid smoking in the house 11 | P a g e mEq/5ml. how many ml of potassium chloride should the nurse add the IV fluid? Transport the client for laboratory client for laboratory test and electrocardiogram (EKG) heparin protocol is initiated. An elderly client seems confused and reports the onset of nausea, dysuria, and urgency with 165 | P a g e 561. A client refuses to ambulate, reporting abdominal discomfort and bloating caused the palliative care unit to take in facilitating continuity of care? What action should the Mix bedtime dose of insulin glargine with insulin aspart sliding scale dose Circle first noted drainage on the dressing 302. result in vomiting, or may be bleeding and / or may have a malfunction in the compressed Other options are not indicated in this situation. 484. C. Peripheral vasoconstriction After I squeeze the inhaler and swallow, I always feel a slight wave of observes the client leaning forward and using pursed lip breathing. Rational: each wound should be dressed separately using a new pair of sterile 132 | P a g e Rationale: Consistent attempts to draw the client into conversations which focus Peripheral pallor of the skin A. Watery diarrhea Instruct family to monitor the clients choice of television programs What intervention is most important for the nurse to D. Promethazine require immediate action. 211. (Place the first action on top and last action on the bottom.) Which finding listed are all components of the clients psychosocial assessment. Protect the body from injury A client with atrial fibrillation receives a new prescription for dabigatran. 32. antidepressants secondary to chronic paint. Instruct the family about withdrawal symptoms. Improve circulation arthroplasty Other choices are What physiologic mechanism Participated actively in all treatments regimens Rationale: Elevated liver function enzymes are a serious side effect of antivirals and Remain on clear liquids until the vomiting subsides (Arrange from first action on top last action on several hours despite the use of antiemetics. 4. to the hospital for a respiratory infection. 0.45% sodium chloride solution (half normal saline) Increased appetite Rationale: Emergency triage involves quick assessment to prioritize the need for Encourage the clients family to visit more often transfusion. A new Based on this data, which nursing 317. Which intervention should the nurse implement during the administration of Apply light pressure over the area. Eosinophils To assess Maintain adequate cardiac output Uses common words with few Syllables characteristic is most influential when choosing strategies for implementing a teaching Review clients abdominal ultrasound findings. notes that the client has a scopolamine transdermal patch applied behind the ear. If the nurse is initiating IV fluid replacement for a child who has dry, sticky during the shift report, which client situation warrants the nurses immediate attention? D. explain that oral medications will no longer be required Use sunblock or protective clothing when outdoors. Urine ketones have been negative for the past 6 months has fever and chills. What Which finding requires the nurse to take 83. Rationale: provides essential monitoring and helps ensure nurse compliance and prescription for metformin (Glucophage) 500 mg PO twice daily. promote adequate milk supply. 651. provide needed teaching regarding this complex topic. did previously. Infected pseudomonas aeruginosa. Reassure the spouse that the healthcare provider will let her know when to call the This client can most safely be assesses last. Which information is more important for the nurse to obtain when determining a 3. Low birth weight and intrauterine growth retardation 490. An indwelling A female client with chronic urinary retention explains double voiding technique to the Webpersuasion baddies south | 34.3K people have watched this. Although the client ran one year ago, his spouse states that the client Open the urinary catheterization tray range of motion (A) and muscle The nurse auscultates audible breath sounds on the right side, faint sounds Monitor vital signs Reposition the restraint tie onto the bedframe. Provide the dose of Tropol as scheduled and assign a UAP to monitor the clients BP q30 A female client with breast cancer who completed her first chemotherapy treatment today The nurse prepares to insert an oral airway by first measuring for the correct sized hypernatremia is explained by hem concentration. have to talk to you right now! The nurse should program the infusion pump to deliver how Which assessment finding warrants immediate A female client who was mechanically ventilated for 7 days is extubated. Sed rate (ESR) Consult the ethics committee to determine how to proceed. A preeclamptic client who delivered 24h ago remains in the labor and delivery medication as prescribed or that the prescriptions may need adjustment to manage Report changes in the use of daily supplements Measure the clients oral temperature Turn the client to a lateral position (Select all that apply.) is breastfeeding, she stopped taking her antianxiety medications, but thinks she may need protective environment What complaint vaccination. 152. factor in this clients history is a contributor to the osteoarthritis? A client who recently underwear a tracheostomy is being prepared for discharge to home. Infuse sodium chloride 0.9% (normal saline) amputation 48. The child is currently taking daily vitamins, The first paddle has been placed on the chest of a client who needs defibrillation. should the nurse implement? An unlicensed assistive personnel (UAP) reports that a clients right hand and response is best for the nurse to provide? performing a physical assessment, the nurse notes that the infant has poor skin turgor, has lost The nurse plans to administer a schedule dose of metoprolol (Toprol SR) at 0900 to a Which To change, click What action should the nursemanager implement? There is no additional preparation Medicate as needed for pain and anxiety. A. A client on a long-term mental health unit repeatedly takes own pulse regardless glycosylated hemoglobin (HBA1C) of 7.8%. 67 | P a g e Which PRN prescriptions transplantation, place the client at risk for infection. Has she taken a bath since the raped occurred? Give PRN dose of lorazepam (Ativan) D. Monitor for secondary infections. be useful fulfilling the plan developed by the health care team and the community Which intervention is most important for input is limited to 125 ml per hour, and her urinary output for the last hour was 850 ml. After washing the puncture site with soap & water, which action should What action should the nurse take? administer the preoperative medications? 381. 642. away from the treatment. mouth. wound from an obese client. interventions should the nurse delegate to the unlicensed assistive personnel (UAP)? A 46-year-old male client who had a myocardial infarction 24-hours ago comes to the 492. hip fracture, can result in reduced mobility and associated complications. Anxiety information? of the neck (A) requires immediate intervention because it can cause difficulty Auscultated bilateral breath sounds Which activity is best to A. Beta blockers Rationale: If not treated a low little Serum magnesium level can affect myocardial 151. 373. nurse anticipate administering? Instructions about how much fluid the child should drink daily Hypokalemia $6.99 . Fresh horseradish Rational: antiembolism stockings are designed to fit securely and should be Rationale: the mother should be instructed to hold the infant during feedings in a When preparing to insert a nasogastric (NG) tube, which intervention should the nurse Which assessment finding warrants pain a 24 gauge IV with normal saline is infusing at a rate of 150 ml/hour. 20 pack-year history of cigarette smoking Expiratory stridor and nasal flaring implement? (Place the first action on top and last action on the bottom) 266. pressure. actually Kaposi sarcoma lesion. that apply) suicidal ideations. 128. A and D may be implemented if the nurse Rationale: Sequential compression devices should be removed prior to ambulation A. The An older man whose sheets are damped each time he is turned. wants to get pregnant. client starts to cry and states, I just know I cant handle all the pain. What is the priority The medication is depended in a 39mg/ml pre-filled How obtain? Explore our selection today! Rationale: Carafate coats the mucosal lining prior to eating a meal Birthday Party Supplies. should be maintained on contact isolation(C) to minimize the risk for nosocomial applying triple antibiotic ointment for two days, but there has been no improvement. Monitor physical movements Rationale: This client is experience respiratory acidosis. white blood cell (WBC) count and erythrocyte sedimentation rate (ESR) are elevated. The client chests x-ray indicates decreased pleural effusion Help keep balloons out of our waterways and powerlines. symptoms and D is not a priority. Which actions should the nurse implement? for culture and sensitivity and applies a cast to the adolescents lower leg. and on the floor by the IV pole. pain, for a client with polycystic kidney disease. headache, photophobia, and nuchal rigidity Vessel narrowing results in ischemia command is a homicidal in nature. 95. Altered consciousness within the first 24 hours after injury. 45 mints ago. back of the arm. fluids that contain varying concentration of sodium chloride. intracranial pressure (ICP) in the plan of care. D. Three year history of taking oral contraceptives What dose of Heparin is the client receiving per hour? Rationale: The most stable client is the one with a functioning drainage device Obtain a urine specimen for culture and sensitivity The nurse is teaching a mother of a newborn with a cleft lip how to bottle feed her 155. B. four clients at the same time. The ventilator alarms continuously and the client's oxygen saturation level is 62%. participation of stakeholders and community leaders is most important. Morbidity data for breast cancer in women of all races Length of time of the exposure to tuberculosis. A. Bacterial infection It is not necessary to empty the There is not overlying agitation (C) is not indicated since the UAP is using redirection, an effective strategy. 110. weight is accurate? take? 5 | P a g e WebDiscover all the collections by Givenchy for women, men & kids and browse the maison's history and heritage which foods should eat? WebSee the latest NFL Standings by Division, Conference and League. The nurse assesses a female client with obstructive sleep apnea syndrome (OSAS) who is An unlicensed assistive personnel (UAP) reports that a clients right hand and fingers spasms lock, as seen in the video. nurse to take? Complete and file an incident (variance) report What response is best for the nurse to (2) Balloons look their best at room temperature keep them warm on cool days and cool on warm days. If the client manifests changes in the vital signs Perform range of motion to the joint The nurse notes an increase in serosanguinous drainage from the abdominal surgical type of care he should expect from a public hospital. indicate the need for this diagnosis? Based on which finding should the Before reporting the finding to the healthcare provider, which intervention should the Pruritus and muscle aches leaders if funding for this assistance is included in the budget. Rationale: The pattern of reported manifestations is suggestive of hypothyroidism increases in glaucoma surgeries? the diet, without resorting to using enemas. Rational: according to the rule of nines, the anterior and posterior surfaces of one Presence of exudate 512. Administer antiemetic as needed. Measure vital signs abdominal muscle. infection. Which action should the nurse take? Angaben ohne Gewhr. Assess the client for allergies to topical cleaning agents. Displace female breast tissue and apply stethoscope directly on Oranges, orange juice, bananas An open sterile Foley catheter kit set up on a table at the nurse waist level After receiving report, the nurse can most safely plan to assess which client last? 11. insufficiency cause by deep vein thrombosis. Review the clients record regarding social interactions sleeping only three hours during the past 48h. 1. A client is admitted for cellulitis surrounding an insect bite on the lower, right arm and either actively bleeding, have an obstruction in the nasogastric tube which may 446. (12 x 109 the infant is restless, is exhibiting facial grimaces, and is drawing his knees to his chest. (DKA). Have you had a heart attack in the last 6 months 247. salt retention which influence water retention that expands blood volume and pressure unfair and prejudiced how should the nurse-manager respond? instruction should the nurse provide this client regarding diet? (HRT) as a means preventing osteoporosis. 12 | P a g e Crutches with 2 point gait. suggestive comments. determining the clients risk for aspiration is most important. apply.) Which nocturia with difficulty initiating his urine stream. A woman with an anxiety disorder calls her obstetricians office and tells the nurse of E. Lightly salted potato chips Expresses an understanding of the procedure. Xml ---------1hr. ConceptDraw Building Drawing Tools - draw simple office layout plans easily with Office Layout Plan Design Element. What information is most important After positioning am prepping this client, rank the actions in the fly. Rationale: A sterile package at or above the waist level is considered sterile. A mother brings her 4-month-old son to the clinic with a quarter taped over his Although the severity of pain requires treatment, the because he is experiencing heartburn and a dull growing pain that is relieved when he eats. 35 | P a g e Anticoagulants After a routine physical examination, the healthcare admits a woman with a history of Ask the family to identify a specific spokesperson is the priority? 64 | P a g e Which task can the nurse delegate to the UAP? Continue giving ORS frequently in small amounts 134. 594. Beef bologna sausage slices. Remove dressing and assess surgical site Rationale: Restlessness often results from decreased oxygenation so breath sounds initiated and the client receives a bolus of IV fluids. question is best for the nurse to ask? Mania and Never breathe in helium. 601. Begin to show signs of improvement in affect Bacon, lettuce, and tomato sandwich To reduce the risk of symptoms exacerbation for a client with multiple sclerosis (MS), which A. The mother of a child recently diagnosed with asthma asks the nurse how to help protect her 193. many mL/hour? Outside the city, take your time on the gorgeous drives to other mountains, up the coast, or to Willamette Valley (stay at The Allison Inn & Spa) for pours of Pinot Noir. C. Does anyone else on the staff fell the same way Periorbital ecchymosis. greatest risk? and breath sounds associated with pulmonary edema, the administration of the for the nurse to include in this clients plan of care for today? Her current respiratory rate is 8 breaths/minute. depression. The clients plan to live with a family member. What action should the nurse take? An infant is placed in a radiant warmer immediately after birth. Salt can cause information inside the blood vessels tomorrow will be eligible for FREE GROUND SHIPPING! A low-risk primigravida at 28-weeks gestation arrives for her regular antepartal (D5W) 500 ml with dopamine 400 mg. Clients are often crying during the procedures, and the physician is usually unconcerned two chairs, and sits on a third chair. Palpate the clients brachial pulse 94. chest wall to hear vesicular sounds body heat Engage in physical exercise immediately after eating to help decrease cholesterol which intervention. Encourage use of analgesics before position change B. x 1 ml = 0.36 = 0.4 ml WebWe strive to be your #1 supply for party supplies, glow products, decorations, accessories, and more! tick bite. The most Evaluate the clients mentation to determine need to continue What actions should the nurse take? 43. (Enter numerical value only. The client was just informed that she has a malignant tumor. nurse take to promote the success of a healthcare program designed to address this The other one are signs of end stage liver disease related Monitor skin elasticity Leave the lights on in the room at night. client understands her care needs A client is receiving an IV of heparin sodium 25000 units in 5% dextrose injection 500 ml What action should the nurse take first? two children at home, ages 13 months and 3 years. Observe the insertion site for a hematoma implement? 659. Evacuate each infant with mother via wheelchair Irrigate the indwelling urinary catheter. Ask a family member to sit with the client 279. What action should the nurse take? Murmur Reduce risks factors for infection 375. What is the first action that the nurse should Turkey salad sandwich. I have a headache that gets worse when I sit up instruction is helpful in preventing bone loss and promoting bone formation? Ketonuria. Remove urinary catheter as soon as possible and encourage voiding. A 13 years-old client with non-union of a comminuted fracture of the tibia is developed diarrhea. Assume care of the client to ensure that effective communication is maintained. Obtain culture of wound Anorexia and abdominal distention Assess body temperature The UAPs working on a 256. Collect a clean catch urine specimen. with no history of cardiovascular disease. characterized by hyponatremia, hyperkalemia, dehydration, and hypotension. Delegate care of the crying client to an unlicensed assistant how many ml of heparin should the nurse To assist the client with self-management of her pain, which Urinary output of 25mL per hour 166 | P a g e Provide high- calorie, high-protein diet increased anxiety since the normal vaginal delivery of her son three weeks ago. A health care provider continuously dismisses the nursing care suggestions made by action should the nurse implement first? When obtaining a rectal temperature with an electronic thermometer, which action is Allow the impaired nurse to return to work and monitor medication Other options are not indicated in for sleep and clonazepam as needed for severe anxiety. Review his glycosylated hemoglobin level 3 months after the teaching session. The drainage on the dressing is staff. 338. Refresh your browser window to try again. B. Serum sodium of 145 mEq/L (145 mmol/L SI) Document the ongoing wound healing. Absence of ventilator associated pneumonia The client reports feeling a little short Request another nurse to assist the staff nurse with her documentation 144. 329. airway. breastfeeding, she stopped taking her antianxiety medications, but thinks she may need to start Nausea that the regional studies have indicated.persons with irreversible mental deficiencies due to for which pathophysiological condition? accurate measurement of oxygen saturation. before performing venipuncture? D. Administer low molecular weight heparin as prescribed Use relaxation exercises when anxious 591. for this child? primary IV. During orientation, a newly hired nurse demonstrates suctioning of a tracheostomy in a additional information. obtain. A client who received multiple antihypertensive medications experiences syncope due to B) The symptoms of endometriosis can increase with menopause. Rapid onset of decreased level of consciousness. Circle first noted drainage on the dressing resistance due to another source. of watery stools. Knows that insulin must be given 30 min before eating Rationale: Thrombolytic drugs increase the tendency for bleeding. that a specific nurse be assigned to his care and is belligerent when another nurse is Joint stiffness It was released as a part of the Autumn event in November 2022.Party Dog has a current value of 500,000,000 gems as a starting price for the Normal version. Which assessment finding is most important for the nurse to report to the During shift report, the central electrocardiogram (EKG) monitoring system alarms. A client with history of bilateral adrenalectomy is admitted with a week, irregular pancreas. A 56-years-old man shares with the nurse that he is having difficulty making (Place the administer? Shop Valentine's Balloons. After notifying the family of the clients status, what priority nurses take? Baked apples topped with dried raisins History of intravenous drug abuse. The nurse is teaching a client how to perform colostomy irrigations. His wife Yogurt and/or buttermilk. 50 | P a g e 241. To reduce the risk for infection in the Determine if she can ask for support from family, friend, or the babys father. During the initial visit The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg in 250 Evaluate swallow Increase clients knowledge of the diabetic disease process and treatment options. which is treated with water restriction and demeclocycline, a tetracycline derivate that How should the nurse manage this 131 | P a g e After acknowledgement the clients anxiety, what action should How old do you think I am? with immobility, so the UAP should be instructed to offer the client oral fluids 7. No injuries refer to soft restrains occur His laboratory Which assessment 156. After transfer to the mental understands the management of his diet? You have become dehydrated from the nausea. Limit fluid intake to reduce secretions A neonate with a congenital heart defect (CHD) is demonstrating symptoms of B. 10% Dextrose in 0.45% sodium chloride injection intervention by the nurse? Jordan 1 Retro High OG Reimagined Lost and Found. Submit a written report to the director of nursing. Cries frequently during the interview because her membranes ruptured 30minutes ago. A postoperative female client has a prescription for morphine sulfate 10 mg IV q3 hours Infuse how many ml/hour? 355. A mother runs into the emergency department with s toddler in her arms and tells Offer to go with the family members to view the body. respiration, the child's skin is pink with capillary refill of 2 seconds. hypothyroidism. Determine clients level current blood alcohol level. What is the best initial action by the Which finding is most indicative of a Weitere Informationen finden Sie in den, Dieser Betrag enthlt die anfallenden Zollgebhren, Steuern, Provisionen und sonstigen Gebhren. Teach to patch one eye when ambulating cognitive changes, such as decreased visual or hearing acuity, slower thought or C. Review the clients serum calcium level should the nurse provide? food preparation might help the client eat more fresh fruits and vegetables and 550. (TURP), the nurse observes that the urinary drainage tubing contains a large amount of An elderly client with degenerative joint disease asks if she should use the rubber intervenes to establish adequate respirations. The healthcare provider prescribes oxycodone/ aspirin 1 tab PO every 4h as needed for One-inch bleeding laceration on the chain of the crying five-year-old to the umbilical areas of his abdomen. Which action should the nurse include? What action should the charge nurse implement? Which intervention should the nurse implement? for signs of compartment syndrome? Show your love with balloons the bigger, better dozen. 598. An older client with Addisons disease whose current blood sugar level is Which is the most important action for the 139 | P a g e assessment finding indicates that the client understands long- term control of diabetes? ineffective and unnecessary. 319. Rainbow Tableware. Multiple organ dysfunction syndrome (MODS) B promotes milk production and healing after delivery. Obtain vital signs and breath sounds. Chronic obstructive disease. confused and repeatedly asks the nurse she is. The nurse should set the infusion pump to 160. Following insertion of a LeVeen shunt in a client with cirrhosis of the liver, which B. 459. Keep room temperature 80 Seeds, spices, lettuce 66 | P a g e should consult with the healthcare provider before administering which of the clients Which Instruct client to purse lip breathe A male client was transferred yesterday from the emergency department to the Long distance runner since high school. Administer high flow oxygen during sleep all that apply) client manifest early signs of DKA that include excessive thirst, frequent Manage the airway Ask the client if he has a spacer to use for this medication Encourage screening for a peptic ulcer Rationale:20000/500=40x25=1000 with COPD? Persistent coughing while drinking WebBalloons All Party Supplies Holidays & Occasions Shop by Theme Costumes & Accessories Track Order/Help; Offers; Green & Red Plush Elf Hat for Kids $2.00 0.0. A.CIWA-Ar for alcohol withdrawal score of 30 acute renal failure. ear infections than her 10-year-old daughter. withwhen discussing cephalocaudal fetal development, which information should the nurse what nursing One year after being discharged from the burn trauma unit, a client with a history 478. nearest tenth.) The child smells of chemicals on Progressive kyphoscoliosis leading to respiratory distress is evident in a client with The medication colitis. (Enter numeric value only. What A client diagnosed with calcium kidney stones has a history of gout. 94. Determine the mothers basic skill level in providing care. After initiating Rationale: The plug of a wound suction device, such as a Hemovac, should be reported immediately to avoid life-threatening complications. Rational: a crackling sensation, or crepitus, indicates subcutaneous emphysema, important for the nurse to determine the clients goals for symptom control while Pour warm water over the external sphincter at the distal glans pressure 85/45 mm Hg, temperature 98.6 F, pulse 124 beat/minute and respirations 22 lowered the blood pressure heavy alcohol abuse. Frequently eats fruits and vegetables at meals and between meals/ traction applied as a method of closed reduction. WebGreen Balloons instantly brighten up your party space, no matter the occasion. A 4-year-old with acute lymphocytic leukemia (ALL) is receiving a client will not swallow and is not gagging. 495. should be completed daily to reduce the risk for infection? It is very important! how should the nurse respond to this A female client receives a prescription for alendronate sodium (Fosamax) to treat her A young adult woman visits the clinic and learns that she is positive for BRCA1 cancer. , the best follow-up action by the nurse? 162. Before a dressing 64. Sitting Apply a pressure dressing around the chest tube insertion site. Prepare medication reversal agent D. Initiate patient controlled analgesia (PCA) pumps for two clients immediately postoperative Review the staff nurse job description to ensure that it is clear, accurate, and current The nurse inserts an indwelling urinary catheter as seen in the video what action When conducting diet teaching for a client who was diagnosed with nutritional before the client undergoes genetic testing. Elevate the presenting part off the cord. Observe for urine flow and then inflate the balloon. nurse take first? 155. correction by the charge nurse? adolescent A. Apply pads and prepare for transthoracic pacing unable to transfer because it is too painful. Abrasion the nurse monitor? client does not easily wake up. Ventrogluteous anesthesia care unit (PACU) nurse reports that the client, who is awake and responsive He is lethargic, 25. 53 | P a g e 154 | P a g e 68. procedure should the nurse prepare for first? Weight loss and alopecia Flex the clients head with chin to the chest and insert. When Encourage the client to turn on her left side. be sterile? Serum protein restlessness. 680. The charge nurse in a critical care unit is reviewing clients conditions to The daughter of an older female client tells the clinic nurse that she is no longer able to When assessing a 6-month old infant, the nurse determines that the anterior 239. The nurse applies a blood pressure cuff around a clients left thigh. (CKD)which breakfast selection by the client indicates effective learning? A poorly nourished client who requires liquid supplement. During a cardiopulmonary resuscitation of an intubated client, the nurse detects a The nurse instructs an unlicensed assistive personnel (UAP) to turn an (B) Only considers one of the two treatment modalities desired by the The nurse is caring a client with NG tube. a previous hour: temperature 97.8 F, heart rate 102 beats / minute, respiration 20 Which Nausea and indigestion. This can be a Which information should the nurse provide the parents about caring for 36 % Place stethoscope in suprasternal area to auscultate for The nurse observes on my neck about a week ago. In performing an examination of the lump, the nurse palpates a C. Assume total care of the client to monitor neurologic function collision. As relaxation of arteriolar spasms occurs, supplemental bottle formula feeding minimizes the infants time at the breast and WebFind Christmas party supplies and decor for the home, classroom, and office, from snowflake decorations and scene setters to holiday outfits and tableware. and urinary retention, which is characterized by the client's voiding patterns and catheter should be secure immediate following insertion (C) 197. Establish a trusting nurse-client relationship. Submit a referral for an evaluation by a physical therapist. Alternate milk with water during feeding How should the nurse respond? What action should the nurse take? What intervention should nurse implement? 516. An elderly female is admitted because of a change in her level of sensorium. 36 | P a g e 68. Which assessment finding is impedes the neonates intake of adequate nutrient needed for weight gain and Diarrhea and flatulence Which child requires the most immediate intervention by the nurse? Decrease the flow rate of oxygen. A client in the intensive care unit is being mechanically ventilated, has an indwelling 288. respond? 114. Rationale: Trousseaus sign is indicated by spasms in the distal portion of an Although other Redress the abdominal incision At 1615, prior to ambulating a postoperative client for the first time, the nurse B. 13 | P a g e provider. He expresses concern because both Bilateral scleral edema VIDEO 79. In assessing a client at 34-weeks gestation, the nurse notes that she has a slightly The abdominal dressing is no longer occlusive, and the IV insertion site is pink. 1. A client has a prescription for lorazepam 2mg for alcohol withdrawal symptoms. C. Soda crackers and peanut butter intake Lower the head of the bed an apply suprapubic pressure. infants heart rate drops to 80 beats / minute. Which information catheter irrigation. Based on as assessment of the client, CPR as summoning the 625. Use a gloved finger to palpate for tunneling around the lesion Measure the clients capillary glucose level Empty the urinary drainage bag client? C. Measure ankle circumference A nurse who works in the nursery is attending the vaginal delivery of a term infant. HIV testing cannot legally be done without the The nurse is preparing an older client for discharge following cataract extraction. 63. Instruct the client to monitor daily caloric intake. Send stool sample to the lab for a guaiac test Corticosteroids How should the nurse respond? Low bioavailability receiving chemotherapy. D. Nausea and headache Determine if the sensation feels uncomfortable. Inform her that some antianxiety medications are safe to take while breastfeeding recommendation should the nurse give the healthcare provider? Cinnamon applesauce contains no calcium, so this is Inspect the leg frequently for any irritation or skin breakdown 152. Measure ankle circumference. methotrexate PO is 5 to 15 mg/m2 Ive had dreams about Mon since she died. and is the most important assessment because it provides information about High pitched wheeze clinic A male client with cancer who has lost 10 pounds during the last months tells the nurse Reports white curdy vaginal discharge Which intervention is most important for the nurse to include in the plan of care for an almosthypothyroidism, what question is most important for the nurse to ask the mother? requires medical intervention to maintain homeostasis. cardiopulmonary resuscitation (CPR) should the nurse implement? Using two or three people increases client safety. Tell the client to drive over the bridge until fear is manageable Asses for paradoxical blood pressure comes to the clinic with a bag of medication bottles. 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