mystery
At 1000 your patient is scheduled to take a dose of Atenolol. What finding below would require you to hold the scheduled dose and notify the physician?*
A. The patient's heart rate is 120 beats per minute.
B. The patient's blood pressure is 102/76.
C. The patient has swelling in lower extremities, dyspnea, and crackles in lung fields.
C. In option C, the patient is showing signs and symptoms of uncompensated heart failure (beta blockers are not used when uncompensated heart failure presents, but they can be sometimes be used when the patient is in compensated/stable heart failure). The reason is because beta blockers slow down the heart rate and decrease the strength of contractions (negative inotropic effect), which can lead to heart failure in SOME patients, and this is why the nurse must monitor for this.
A nurse working the evening shift has five patients and is teamed up with an assistive personnel. One of the assigned patients has just returned from surgery, one is newly admitted, and one has requested a pain medication. The patient who has returned from surgery just minutes ago has a large abdominal dressing, is still on oxygen by nasal cannula, and has an intravenous line. One of the other patients has just called out for assistance in setting up a meal tray. Another patient is stable and resting comfortably. Which patient is the nurse’s current greatest priority?
1. Patient in pain
2. Patient newly admitted
3. Patient who returned from surgery
4. Patient requesting assistance with meal tray
Answer: 3. The patient returning from surgery is likely the most physiologically unstable, requiring the nurse to perform an assessment and ensure that the patient is managed appropriately. The patient in pain is likely to be the next priority, depending on the severity of the patient’s reported pain. The newly admitted patient will require a nursing history, which takes time. The nurse can have the assistive personnel assist with the meal tray
Cautions with Acetametophen?
Liver/Kidney issues, adrenal disease, drinker, hypokalemia
2. Choose which outcomes can be expected with opioids:
Sedation
Respiratory depression
Tachycardia
Decrease in BP
Orthostatic hypo
Anorexia
Urinary retention
N/V
Sedation
Respiratory depression
Decrease in BP
Orthostatic hypo
Urinary retention
N/V
How do we protect pt from aspiration?
Sit them up, offer water beforehand, allow patient to self-administer medications if possible, time with meals if possible
List the routes of medication from slowest to fastest.
A nurse is caring for an older adult client in a long-term care facility. The client has become weak and confused. He ate 40% of his breakfast and lunch. The client's temperature is 100.9 degrees F, pulse 92/min, respirations 20/min, and blood pressure 108/60mmHg. He has lost 3/4 lb and reports dizziness when assisted to the bathroom. He also has a nonproductive cough with diminished breath sounds in the right lower lobe. Which of the following actions should the nurse take?
A. Initiate fluid restrictions to limit intake
B. Observe for signs of peripheral edema
C. Encourage the client to ambulate to promote oxygenation
D. Monitor for orthostatic hypotension
D
A patient with deep vein thrombosis is receiving an infusion of heparin and will be started on warfarin (Coumadin) soon. While the patient is receiving heparin, what laboratory test will provide the nurse with information about its therapeutic effects?
Antithrombin III
International normalized ratio (INR)
Activated partial thromboplastin time (aPTT)
Platelet count
3
Rationale: Therapeutic effects of heparin are monitored by the aPTT. While the patient is receiving heparin, the aPTT should be 1.5 to 2 times the patient’s baseline, or 60 to 80 seconds. Options 1, 2, and 4 are incorrect. Plasma antithrombin III is activated by heparin to exert anticoagulant effects but is not used to measure heparin activity. An INR is used to monitor the effectiveness of warfarin (Coumadin). Platelets are not affected by anticoagulant therapy and are not useful in monitoring the therapeutic effects of the drug.
What are the risks or negative outcomes of NSAIDS?
stomach upset, ulcers, GI bleeding
Which category do acetemetophen/tylenol fall into?
antipyretic, non opioid analgesic
Which problems come first when setting priorities?
Airway, Breathing, Circulation
Acute Before Chronic
Significant changes in vitals, life threatening labs
What are some second level priority problems?
Fresh post op, altered mental status, acute pain, acute elimination problems, abnormal labs
What do we monitor in pt on anticoagulant drugs?
bleeding gums, tarry stools, unusual bruising, nosebleeds
What do you do if your pt is having serious pain before their medication is due?
call provider
A nurse is assessing a client for Chvostek's sign. Which of the following techniques should the nurse use to perform this test?
A. Apply a blood pressure cuff to the client's arm.
B. Place the stethoscope bell over the client's carotid artery.
C. Tap lightly on the client's cheek.
D. Ask the client to lower her chin to her chest.
C. Tap lightly on the client's cheek.
The nurse taps the client's cheek over the facial nerve just below and anterior to the ear to elicit
Chvostek's sign. A positive response is indicated when the client exhibits facial twitching on this side of her face.
Warfarin is indicated in (list 3 or more diagnoses where the PT would need warfarin)
venous thrombosis, PE, preventing thrombous, AFIB, decreases risk further/future emboli, prevents thrombus after heart valve replacement.
. A patient is admitted to the ER with the following findings: heart rate of 110 (thready upon palpation), 80/62 blood pressue, 25 ml/hr urinary output, and Sodium level of 160. What interventions do you expect the medical doctor to order for this patient?*
A. Restrict fluid intake and monitor daily weights
B. Administer hypertonic solution of 5% Dextrose 0.45% Sodium Chloride and monitor urinary output
C. Administer hypotonic IV fluid and administer sodium tablets.
D. No interventions are expected
B. The patient must be re-hyrdated and the sodium levels should be decreased at the same time. So a hypertonic solution of 5% dextrose and 0.45% NA will help do this. The solution is hypertonic because of the 5% Dextrose which will rapidly metabolize to the cells. When the dextrose metabolizes to the cells it leaves behind 0.9% NA which acts as a isotonic solution. This allows the 0.45% NA to act as a hypotonic solution to repair the vascular compartment. After these fluids are infused the patient's NA level should decrease, BP increase, HR return to normal etc. It is a complicated physiological process because the Dextrose has unique capabilities when it is metabolized....although the solution is labeled as hypertonic it becomes a hypotonic solution when the Dextrose is metabolized by the cells.
1. What type of drug is an opioid?
1. Analgesic (pain relief)
What do we treat with beta blockers?
Arrhythmia
Angina
Tachycardia
What is ADPIE?
Assessment, Diagnosis, Planning, Implementation, Evaluation
What is a normal platelet value in an adult?
What happens if a platelet count is low or high?
1. 150,000-400,000
2. Low=difficulty clotting, high=risk of clot
How does a toxic drug effect happen?
Renal system is unable to metabolize medication, so effects just keep building and building.
Within what time must critical medications be administered?
30 minutes
List 4 concerns when administering medications to older adults.
decreased kidney and liver functions, decreased vision, altered memory, increase # of polypharmacy
What are signs and symptoms of fluid overload?
SOB, tachycardia, edema
name some potassium rich foods.
bananas, potatoes, oranges, spinach...
Acetaminophen is not an NSAID, but it is an analgesic.
1) What about the side effects of Acetaminophen make it different from an NSAID? 2) What type of patient should be monitored carefully if using Tylenol?
1. Not indicated for GI bleeding
2. Liver issues, patients who drink
A patient is prescribed Metoprolol. Which statement by the patient requires the nurse to re-educate the patient on how to take the medication properly?*
"After I stop taking this medication I will let my physician know."
"I take this medication with my breakfast every morning."
"I will change positions slowly while I'm taking this medication."
"While I'm taking this medication I will monitor my heart rate."
A. The patient should NOT just stop taking the medication. It must be tapered off over a period of time (usually about 2 weeks). This will prevent the development of rebound hypertension, myocardial ischemia, and angina.
What do you hear in pt lungs if they have atelectasis?
diminished breath sounds
PTT
1.What does it do?
2. What do low and high levels indicate?
3. What are normal values?
1. measures the time it takes for a clot to form in a blood sample
2. low=risk of clot,high=risk of bleeding
3. 60-70s
What would you tell a pt who is going home for the first time on warfarin?
soft toothbrush, careful w/ flossing, careful with razors, do not drink alcohol, be careful with NSAID OTC
4. A charge nurse is teaching a group of nurses about conditions related to metabolic acidosis.
Which of the following statements by a unit nurse indicates the teaching has been effective?
A. "Metabolic acidosis can occur due to diabetic ketoacidosis."
B. "Metabolic acidosis can occur in a client who has myasthenia gravis."
C. "Metabolic acidosis can occur in a client who has asthma.'
D. "Metabolic acidosis can occur due to cancer."
A Metabolic acidosis results from an excessive production of hydrogen ions, which occurs in diabetic keto acidosis
A nurse is caring for a client admitted with confusion and tingling of the extremities after ingesting an unknown number of aspirin, Vital signs reveal a blood pressure of 104/73 mm Hg, heart rate 116/min and regular, and a respiratory rate of 30/min. Which of the following arterial blood gas findings should the nurse expect?
A. pH 7.68 Pa0, 96 mm Hg PaCO, 38 mm Hg
HCO, 28 mEg/L
B. pH 748 PaO, 100 mm Hg PaCO, 28 mm Hg
HOO, 23 mEg/L
C. oH 7.25 PaO, 100 mm Hg PaCO, 43 mm Hg
HO, 23 mEg/L
D. pH 7.58P80, 96 mm Hg PaCO, 38 mm Hg
HCOr 29 mEg/L
B An aspirin toxicity would result in arterial blood gas findings of respiratory alkalosis
Choose the VERY severe symptoms of hypovolemia.
1.Tachycardia
2. sudden change in LOC
3. Seizure
4. increased HgB
5. increased HCT
6. Thready pulse
7. Weakness
8. increased BUN
9. Poor skin turgor
10. decreased sodium
11. Increased sodium
2. LOC
3. seizure
5. increased HCT
7. weakness
8. increased BUN
11. increased sodium
A nurse is caring for a client who has a serum sodium level 133 mEq/L and serum potassium level 3.4 mEq/L. The nurse should recognize that which of the following treatments can
result in these laboratory findings?
A. Three tap water enemas
B. 0.9% sodium chloride solution IV at 50 mL/hr
C. 5% dextrose in water solution with 20 mEq of K+ IV at 80 mL/hr
D. Antibiotic therapy
A. Three tap water enemas
Three tap water enemas can result in a decrease in serum sodium and potassium. Tap water is hypotonic, and gastrointestinal losses are isotonic. This creates an imbalance and solute dilution.
What are signs of opioid toxicity?
1. Increase in temperature
2. Respiratory depression
3. Pinpoint pupils
4. Diarrhea
5.Coma
2. Respiratory depression
3. pinpoint pupils
5. coma
What are indicators of an allergic reaction?
wheezing, BP down, constriction of brachial muscles, rash, edema in pharynx and larynx.
List aspects of assessment.
vitals, history, labs, meds, allergies
Hemoglobin:
1.What does it do?
2. What diagnosis do low and high levels indicate?
3. What are normal values?
1. Carries oxygen to cells
2. low=anemia, high=polycythemia
3. Female: 12-16 g/dL; male: 14-18 g/dL
An 82-year-old patient who resides in a nursing home has the following three nursing diagnoses: Risk for Fall, Impaired Physical Mobility related to pain, and Impaired Nutritional Intake related to reduced ability to feed self. The nursing staff identified several outcomes of care. Match the diagnoses on the left with the appropriate outcome statements on the right.
Diagnoses
___ 1. Risk for Fall
___ 2. Impaired Physical Mobility related to pain
___ 3. Impaired Nutritional Intake related to reduced ability to feed self
Outcomes
a. Patient expresses fewer nonverbal signs of discomfort when walking within 24 hours.
b. Patient increases calorie intake to 2500 calories daily.
c. Patient walks 20 feet using a walker in 24 hours.
d. Patient identifies barriers to remove in the home within 1 week.
1 d; 2 a and c; 3 b.
What must be listed in a med order?
What do we do to prevent atelectasis?
Coughing, deep breathing, incentive spirometer, sit in the chair
What are causes isotonic hypovolemia?
GI loss (vom or diarrhea)
Renal losses due to disease or diuretics
Excessive sweating
3rd spacing (burns)
Sepsis
Hemorrhage
Altered intake
NPO
List normal values for potassium
3.5-5 mEq/L
What are we tracking with pts on diuretics? Especially those who might be at risk for fluid and electrolyte irregularities?
*daily weight changes over 2.2lb in 24 hours*, i/o, postural hypotension, N/V, fatigue, weakness, irregular pulse, and leg cramps
1) people with ulcers, cardiovascular issues, renal issues, hepatic issues, alcoholics.
2)Increased risk for stroke, GI bleed, anaphylaxis
A nurse assesses a 78-year-old patient who weighs 108.9 kg (240 lb) and is partially immobilized because of a stroke. The nurse turns the patient and finds that the skin over the sacrum is very red and the patient does not feel sensation in the area. The patient has had fecal incontinence on and off for the last two days. The nurse identifies the nursing diagnosis of Risk for Impaired Skin Integrity. Which of the following outcomes is appropriate for the patient?
1. Patient will be turned every two hours within 24 hours.
2. Patient will have normal formed stool within 48 hours.
3. Patient’s ability to turn self in bed improves.
4. Erythema of skin will be mild to none within 48 hours.
4. Reduced erythema is the only outcome that measurably assesses the condition of the patient’s skin and within a set time frame. It is realistic. The ability to turn self is an outcome measuring mobility status. Normal formed stool is an outcome focused on improving bowel incontinence. Turning a patient is an intervention and not an outcome.
aPTT
1.What does it do?
2. What do low and high levels indicate?
3. What are normal values?
1. measures how long it takes your blood to form a clot.
2. low=risk of clot, high=risk of bleeding
3. 30-40s
What is an idiosyncratic drug reaction?
Something we wouldn't anticipate - unpredicted
What are 3 types of meds you never crush?
capsules, XR, enteric coated meds
A nurse is caring for a client who was in a motor-vehicle accident. The client reports chest pain and difficulty breathing. A chest x-ray reveals the client has a pneumothorax. Which of the following arterial blood gas findings should the nurse expect?
A. pH 7.06 Pa02 86 mm Hg PaCO2 52 mm Hg
HCO3 24 mEq/L
B. рН 7.42 Pa02 100 mm Hg PaCO2 38 mm Hg
HCO; 23 mEq/L
C. pH 6.98 Pa02 100 mm Hg PaCO2 30 mm Hg
HCO3- 18 mEg/L
D. pH 7.58 Pa02 96 mm Hg PaCO2 38 mm Hg
HCO3 29 mEg/L
A: A pneumothorax can cause alveolar hypoventilation, an increased carbon dioxide levels, resulting in a state of respiratory acidosis
A nurse is admitting a client who reports nausea, vomiting, and weakness. The client has dry oral mucous membranes. Which of the following findings should the nurse identify as manifestations of fluid volume deficit? (select all that apply)
A. Decreased skin turgor
B. Concentrated urine
C. Bradycardia
D. Low-grade fever
E. Tachypnea
A, B, D, E
A nurse is caring for a client who has a serum potassium 5.4 mEq/L. The nurse should assess for which of the following manifestations?
A. ECG changes
B. Constipation
C. Polyuria
D. Hypotension
A. ECG changes, The nurse should assess for ECG changes. Potassium levels can affect the heart and result in arrhythmias.
Do Beta Blockers have a parasympathetic effect or sympathetic effect?
Parasympathetic. Because it's blocking the sympathetic nervous system. They prevent the sympathetic nervous system stimulation of the heart
If we're giving an adrenergic med, alpha adrenergic does what to smooth muscles of arteries and blood pressure?
1. Constrict, lower
2. Constrict, raise
3. Relax, lower
4. Relax, raise
2
A nurse is assessing a client who has pancreatitis.
The client's arterial blood gases reveal metabolic acidosis. Which of the following are expected findings? (Select all that apply.)
A. Tachycardia
B. Hypertension
C. Bounding pulses
D. Hyperreflexia
E. Dysrhythmia
F. Tachypnea
E, F: Dysrhythmia and tachypnea is an expected, finding in a client who has pancreatitis and metabolic acidosis.
Hematocrit:
1.What is it?
2. What do low and high levels indicate?
3. What are normal values?
1. % of blood that is RBC
2. Low=fluid overload, high=dehydration
3. Female: 36%-47%; male: 40%-52%
Which vitamin dependent factor does warfarin interfere with?
1. D
2. B
3. K
4. C
3: interferes with vit k dependent clotting factors
PT
1.What does it do?
2. What do low and high levels indicate?
3. What are normal values?
1. Measures how long it takes for a clot to form in a blood sample
2. low=risk of clot, high=risk of bleeding
3. 11-12.5s
Categorize early and late signs of hypoxia.
restlessness and anxiety
slowed HR and RR
decreased LOC
cyanosis
difficulty concentrating
increased HR and RR
difficulty lying flat
behavioral changes
early: restlessness and anxiety, decreased LOC, difficulty concentrating, increased HR and RR, behavioral changes
late: cyanosis, difficulty lying flat
Choose the correct s/s of Hypovolemia
1. Rapid weight gain
2. Edema
3. Decrease in temp
4. Tachycardia
5. Increase in HR
6. Decrease in BP
7. Increase in BP
8. Bradycardia
10. Poor skin turgor
11. dark urine
12. Thready Pulse
3. Decrease in temp
4. Tachycardia
5. Increase in HR
6. Decrease in BP
10. Poor skin turgor
11. dark urine
12. Thready Pulse
List normal values for sodium
136-145 mEq/L
What actions do beta blockers have on the heart? Select all that apply.
1. Decrease Clotting
2. Decrease SA node firing
2. Decrease AV node firing
4. Decrease HR
5. Increase HR
1. Decrease SA node firing (slow SA node)
2. Decrease AV node firing (slow electric transmission)
4. Decrease HR
A charge nurse is reviewing the steps of the nursing process with a group of nurses. Which of the following data should the charge nurse identify as objective data?
1. Respiratory rate is 22/min with even, unlabored respirations.
2. The client's partner states, "They said they hurt after walking about 20 minutes ago"
3. The client's pain is a 3 on a scale of 0-10
4. Skin is pink, warm, and dry.
5. The assistive personnel reports the client walked with a limp.
1, 4, 5. Objective data is the data the nurse obtains through observation and examination, including information from the observation of others (family and staff)
The patient receiving heparin therapy asks how the “blood thinner” works. What is the best response by the nurse?
“Heparin makes the blood less thick.”
“Heparin does not thin the blood but prevents clots from forming as easily in the blood vessels.”
“Heparin decreases the number of platelets so that blood clots more slowly.”
“Heparin dissolves the clot.”
2 Rationale: Anticoagulants do not change the viscosity (thickness) of the blood. Instead, anticoagulants modify the mechanisms by which clotting occurs. Options 1, 3, and 4 are incorrect. Heparin does not make the blood less viscous or actually thinner and does not decrease the number of platelets or dissolve existing clots. Cognitive Level: Applying. Nursing Process: Implementation. Client Need: Physiological Integrity.
Diziness, fatigue, cold hands and feet, trouble sleeping. The WORST side effect is a true heart block indicated by an apical pulse lower than 60
What do we document with immunizations?
Lot #, manufacturer, and expiration date
3. A nurse is obtaining arterial blood gases for a client who has vomited for 24 hr. The nurse should expect which of the following acid-base imbalances to result from vomiting for 24 hr?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
C: Excessive vomiting causes loss of gastric acid and an accumulation of bi carbonate in the blood, resulting in metabolic alkalosis.
A nurse is admitting an older adult client who is experiencing dyspnea, weakness, weight gain of 2lbs, and 1+ bilateral edema of the lower extremities. The client has temperature 99 degrees F, pulse 96/min, respirations 26/min, oxygen saturation 94% on 3L via nasal cannula, and blood pressure 152/96mmHg. Which of the following manifestations of fluid volume excess should the nurse expect? (select all that apply)
A. Dyspnea
B. Edema
C. Bradycardia
D. Hypertension
E. Weakness
A, B, D, E
A nurse is caring for a client who has a nasogastric tube attached to low intermittent suctioning. The nurse should monitor for which of the following electrolyte imbalances?
A. Hypercalcemia
B. Hyponatremia
C. Hyperphosphatemia
D. Hypomagnesemia
B. Hyponatremia
The nurse should monitor the client for hyponatremia. Nasogastric losses are isotonic and contain sodium.
A patient is prescribed a beta blocker for a cardiac condition. You know this medication blocks the beta receptors in the body so ____________ and __________ cannot bind to the receptor site and elicit a _______ ________ _________ response.
A. angiotensin II and angiotensin I; sympathetic nervous system
B. dopamine and norepinephrine; parasympathetic nervous system
C. norepinephrine and epinephrine; sympathetic nervous system
D. dopamine and acetylcholine; parasympathetic nervous system
C. Beta blockers block the beta receptors in the body so norepinephrine and epinephrine cannot bind to the receptor site and elicit a sympathetic nervous system response.
A 24-year-old patient reports taking acetaminophen (Tylenol) fairly regularly for headaches. The nurse knows that a patient who consumes excessive acetaminophen per day or regularly consumes alcoholic beverages should be observed for what adverse effect?
Hepatotoxicity
Renal damage
Thrombotic effects
Pulmonary damage
3 Rationale: Thrombolytics such as alteplase (Activase) dissolve existing clots rapidly and continue to have effects for 2 to 4 days. All forms of bleeding must be monitored and reported immediately. Options 1, 2, and 4 are incorrect. Skin rash, urticaria, labored respirations with wheezing, or temperature elevation are not directly associated with alteplase, and other causes should be investigated. Cognitive Level: Analyzing. Nursing Process: Evaluation. Client Need: Physiological Integrity.
A nurse is assigned to five patients, including one who was recently admitted and one returning from a diagnostic procedure. It is currently mealtime. The other three patients are stable, but one has just requested a pain medication. The nurse is working with an assistive personnel. Which of the following are appropriate delegation actions on the part of the nurse? (Select all that apply.)
1. The nurse directs the assistive personnel to obtain a set of vital signs on the patient returning from the diagnostic procedure.
2. The nurse directs the assistive personnel to go to the patient in pain and to reposition and offer comfort measures until the nurse can bring an ordered analgesic to the patient.
3. The nurse directs the assistive personnel to set up meal trays for patients.
4. The nurse directs the assistive personnel to gather a history from the newly admitted patient about his medications.
5. The nurse directs the assistive personnel to assist one of the stable patients to sit up in a chair for his meal.
2, 3, 5. The nurse can delegate repetitive, noninvasive tasks to an assistive personnel, such as obtaining vital signs on a stable patient, repositioning a patient, and offering comfort measures, and setting up meal trays. It is inappropriate for the nurse to delegate aspects of the nursing process, such as collecting a medication history. The nurse also should not delegate obtaining vital signs if a patient might be unstable from returning from a diagnostic test.
List normal values for calcium
9-10.5 mg/dL
What is the action of an adrenergic drug (ex Norepinephrine, epinephrine, dopamine)?
1. Stimulates parasympathetic system
2. Stimulates sympathetic system
stimulates fight or flight (sympathetic)
What do we do if a pt refuses?
Educate, call provider, document facts
What are some causes of hypertonic hypovolemia with hypernatremia? (Sodium is higher than water)
Hyperventilation, excessive sweating w/o water intake, fever, DKA, enteral feeding w/o water
A nurse is assessing a client who is dehydrated for fluid volume deficit. Which of the following findings should the nurse expect in the client?
A. Moist skin
B. Distended neck veins
C. Increased urinary output
D. Tachycardia
D
A nurse is assessing a client who has hyperkalemia. The nurse should identify which of the following conditions as being associated with this electrolyte imbalance?
A. Diabetic ketoacidosis
B. Heart failure
C. Cushing's syndrome
D. Thyroidectomy
A. Diabetic ketoacidosis
Hyperkalemia, an increase in serum potassium, is a laboratory finding associated with diabetic ketoacidosis.
What are some complications of a loop diuretic like furosemide?
dehydration, hypokalemia, digoxin toxicity, in severe cases dysrhythmias
What effect do beta adrenergic receptors have?
1. Increase contractility and decrease HR
2. Decrease contractility and decrease HR
3. Increase contractility and increase HR
4. 2. Decrease contractility and increase HR
3
Which are qualities of a nursing diagnosis? Select all that apply. :)
1. Focuses on diseases and illness
2. Remains the same for as long as the disease is present
3. Changes as the patient's needs change
4. Focuses on PT response
3. Changes as the patient's needs change
4. Focuses on PT response
INR
1.What does it do?
2. What diagnosis do low and high levels indicate?
3. What are normal values?
1. Measures efficacy of anticoag therapy
2. Low=risk of clot, high=risk of bleeding
3. 0.8-1.1
What are some contraindications for anticoagulants?
uncontrolled bleeding, recent surgery, severe kidney disease, uncontrolled HTN (which could lead to hemmoragic stroke)
You just gave the wrong medication. What do you do?
1. Monitor PT
2. Tell provider
3. Document
When we have a pt who is on bedrest and very sick, what are our concerns relating to their bedrest?
Blood clots, PE, pressure ulcer
Where is most of the fluid in our body?
1. Bloodstream
2. In cells
3. Out of cells
In our cells (2/3 of our body's fluid)
A nurse is monitoring a patient who takes aspirin daily. The nurse should identify which of the following manifestations as adverse effects of aspirin? (select all that apply)
A. Hypertension
B. Coffee-ground emesis
C. Tinnitus
D. Paresthesias of the extremities
E. Nausea
B: could indicate GI bleed, C, E