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A nurse is caring for a client who reports fatigue and had a syncopal episode at

home.

 

Medical History

40-year-old female admitted with reports of increased fatigue x6 months. States they needs to rest frequently and is unable to participate in many activities due to reduced energy level.

Reports dyspnea on exertion. Experienced syncopal episode at home without injuries.

BMI: 21

Height: 62 inches

Weight: 128.5 lb Denies recent weight loss. Denies anorexia.

 

Past medical history: Has routine well health check-ups. Regular menses cycles, with heavy menstrual bleeding over the last year. Placed on ethinyl estradiol/drospirenone, one tablet PO daily 1 month ago. Denies sexual activity. No other health issues

 

Family history: Mother has hypertension, father has diabetes mellitus, no siblings.

 

Vital Signs

0800:

Temperature 37.1°C (98.8° F)

Apical Pulse 100/min

Respiratory rate 22/min

Blood pressure 102/76 mm Hg

Oxygen saturation 90% on room air

 

Diagnostic Results

Hemoglobin 10.2 g/dL (Male: 14 to 18 g/dL; Female: 12 to 16 g/dL)

Hematocrit 35% (Male: 42% to 52%; Females: 37% to 47%)

 

Nurses’ Notes

0800:

Resting in bed. Alert and oriented x 4. Skin is cool, dry, and pale. Mucous membranes pale and moist. Small fissures noted at corners of mouth. Heart sounds moderate and regular, soft murmur noted. Capillary refill 4 seconds. Lungs clear to auscultation. Abdomen soft with active bowel sounds x 4. No peripheral edema noted. Small 1 cm open area on right heel. Slight redness noted, no drainage noted. Client states wound is from a blister after wearing a new pair of shoes. Reports fatigue and lack of energy. Denies pain or vertigo at this time. Takes 100% of diet. No nausea. The nurse has completed an assessment on the client after the syncopal episode. Complete the following sentence by using the list of options.

 

1200:

Up to bathroom with assistance of one. Reports dizziness. Lowered to sitting position on floor. Helped into bed with assistance of two.

Temperature 37° C (98.6° F)

Heart rate 104/min

Respiratory rate 26/min

Blood pressure 94/59 mm Hg

Oxygen saturation 88% on room air

 

The nurse has completed an assessment on the client after the syncopal episode. Complete the following sentence by using the list of options.

 

The nurse should first address the client’s _____(A)_____, the client’s ______(B)______ followed by

 

Word Choices:

(A)

oxygen saturation

glossitis

hemoglobin

increased fatigue

paresthesia of the feet

 

(B)

decreased energy level

hypotension

wound on heel

heart murmur

pale and cool skin

SCIENCE
HEALTH SCIENCE
NURSING
NURS 5541

 

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