Stress & Adaptation
What hormone controls blood glucose during stress, increases the breakdown of fats, and inhibits the release of insulin?
Epinephrine
A student nurse is caring for a 72-year-old client with Alzheimer's disease who is very confused. Which is the most appropriate communication strategy to be used by the student nurse?
a.Written directions for bathing
b.Speaking very loudly
c.Gentle touch while providing ADLs
d.Flat facial expression
C. gentle touch while providing ADLs
Which of the following are most likely to be early signs of cardiac problems in older persons? (Select all that apply.)
Mental status changes
Agitation
Frequent falls
Sudden changes in GI function
Mental status changes
Agitation
Frequent falls
Rationale: Many cardiovascular functions are complicated in that they involve many other systems. Mental status changes, agitation, and falls can be early signs of cardiac problems in the older person. Changes in function in the GI system are not typical signs of a cardiac problem.
A client is returned to the nursing unit following thoracic surgery with chest tubes in place. During the first few hours postoperatively, the nurse assisting in caring for the client checks for drainage. Which type of drainage is expected?
Bloody
The nurse is communicating with a well-oriented older adult client in a long-term care setting. Which statement best reflects respectful and caring communication?
a."Are we ready for our shower?"
b."It's time to go to the dining room, honey."
c."Are you comfortable, Mrs. Smith?"
d."You would rather wear the slacks, wouldn't you?"
C. "Are you comfortable, Mrs. Smith?"
The nurse cares for a 72-year-old Native American male patient 2 days after a thoracotomy for tumor resection. What would be the most appropriate action if the patient does not report any pain?
Contact the health care provider.
Identify possible reasons for denial of pain.
Administer the prescribed pain medication.
Assess the renal and liver function test results.
Identify possible reasons for denial of pain.
A middle-aged woman's father has passed away, and her mother requires physical and emotional help due to disabilities. The woman is married and raising two children, along with working full time. All of the factors described are
Stressors
Explanation: Stress is defined as any event or set of events, a stressor, that causes a response. Everyday triggers associated with work or social relationships, and uncommon events such as natural disasters, physical trauma, injuries, illnesses, divorce, death of a loved one, or loss of a job are commonly recognized stressors.
The nurse is caring for a client after pulmonary angiography via catheter insertion into the left groin. The nurse monitors for an allergic reaction to the contrast medium by observing for the presence of which?
Respiratory distress
What is the reasoning behind only giving essential medications to hepatitis patients?
because most meds are metabolized in the liver
You are the nurse caring for a 72-year-old female who is recovering from abdominal surgery on the Medical Surgical unit. The surgery was very stressful and prolonged and you note on the chart that her blood sugars are elevated yet she in not been diagnosed with diabetes. To what do you attribute this elevation in blood sugars?
The blood sugars are probably a result of the "fight-or-flight" reaction.
Explanation: During stressful situations, ACTH stimulates the release of cortisol from the adrenal gland, which creates protein catabolism releasing amino acids and stimulating the liver to convert amino acids to glucose, the result is elevated blood sugars. Option A is incorrect, antidiuretic hormone is released during stressful situations and stimulates reabsorption of water in the distal and collecting tubules of the kidney. Option B is incorrect; assuming the patient had diabetes prior to surgery demonstrates a lack of understanding of stress induced hyperglycemia. Option C is incorrect, there is no evidence presented in the question other than are elevated blood sugars that would support a diagnosis of diabetes.
A nurse is caring for a client who is being discharged after cardiac surgery. The client has a prescription for enoxaparin to take at home. Which of the following discharge information should the nurse give to this client?
Use a soft toothbrush for brushing teeth and an electric razor for shaving
Enoxaparin (Lovenox) is a form of low-dose heparin that prevents blood clots. When a client takes this kind of medication, they are at a higher risk of bleeding from even minor cuts or scrapes and should be careful with daily tasks. The nurse can reinforce this by recommending that the client use a soft toothbrush to avoid bleeding gums or an electric razor to avoid cutting himself while shaving.
The low-exhaled volume (low-pressure) alarm sounds on a ventilator. The nurse rushes to the client's room and checks the client to determine the cause of the alarm but is unable to do so. Which would be the next immediate nursing action?
High-grade fever
Sterile is __________ whereas Clean is ___________.
Pick from:
antiseptic
aseptic
Sterile is aseptic whereas Clean is antiseptic.
Which patient would be at highest risk for hypothermia after surgery?
A 42-year-old patient who had a laparoscopic appendectomy
A 38-year-old patient who had a lumpectomy for breast cancer
A 20-year-old patient with an open reduction of a fractured radius
A 75-year-old patient with repair of a femoral neck fracture after a fa
A 75-year-old patient with repair of a femoral neck fracture after a fall
Patients at highest risk for hypothermia are those who are older, debilitated, or intoxicated. Also, long surgical procedures and prolonged anesthetic administration place the patient at increased risk for hypothermia.