PART 1 (multiple choice/ multiple selection) 1.

PART 1 (multiple choice/ multiple selection) 1. The nurse working in an Emergency Department is assisting with the admission of a woman whose last menstrual period was seven weeks ago with acute severe lower right-sided abdominal pain with heavy vaginal bleeding. The client is very pale, and vital signs reveal a pulse of 122 and blood pressure of 86/52. The nurse’s priority action while waiting for the physician is to: A. Inform the client she has an ectopic pregnancy. B. Obtain a complete medical and surgical history. C. Have the client sign a consent for a blood transfusion. D. Place the on-bed rest and retake vital signs. 2. The nurse working in an obstetrician’s office determines that which of the following clients would be considered to have a high-risk pregnancy? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. The woman who had a healthy baby six months ago resulting from a healthy pregnancy The unmarried 14-year-old woman living in a rural area The woman recovering from a gastrointestinal virus The woman who lives in an urban area in a high-rise apartment The woman who drinks one cup of coffee every morning 3. The nurse is preparing an in-service presentation on the stages of labor. The nurse recognizes that the transition phase of the first stage of labor includes: (Select all that apply.) The laboring client may be irritable, angry, and/or restless. Contractions occur every 2 to 3 minutes and last approximately 90 seconds. The average time of transition is 15 to 30 minutes. The client may report a strong urge to push. The transition phase is from 8 to 10 cm. PART 2 (I have already submitted to course hero twice and have gotten an answer which is not clear to me, so please verify the correct answer for me this time) Read the simulation below and answer the following questions: George Jones is a 59-year-old male who went to the emergency department with chest pain. He had experienced this chest pain for 30 minutes and it was not relieved after taking three nitroglycerin tablets 5 minutes apart. He reports the pain feels “dull and like an elephant is sitting on my chest.” He is diaphoretic and appears anxious. His vital signs are temperature 99° F, blood pressure 100/68 mm Hg, heart rate 110 beats/min, and respiratory rate 24 breaths/min. Mr. Jones is overweight and has type 2 diabetes mellitus, hyperlipidemia, and hypertension. He quit smoking last year after a 40-year history of one pack of cigarettes a day. His troponin level is elevated and the EKG shows ST segment elevation. The nurse administers oxygen and draws blood for arterial blood gas analysis. Mr. Jones is told he will have a cardiac catheterization to locate the blockage, determine its severity, and evaluate left ventricular function. As you assess your patient here are your findings. Assessment Neuro assessment negative. No deficits. Strength equal and strong. Lung Sounds (crackles bilaterally) Pedal Edema (2+ pitting) Resp rate = 30 with Dyspnea Oxygen saturations (89%) I&O (I=300 O=50) Foley (dark amber 50ml) Vitals B/P = 170/90 Pulse = 130 Resp = 30 Pulse points (all present) Chest pain (yes) Telemetry = Sinus Tachycardia with S-T elevation Troponin Level = 0.45ng/mL Weight up 5 lbs from last week) Left groin (ok, no bruising or oozing) Pedal Pulses 2+ Color of toes (pale pink) Warmth of toes (slightly cool) QUESTIONS What are you thinking is going on with this patient and what rationale do you have for your thought process? (hint….there are actually 2 exemplars occurring considering the symptoms exhibited with your assessment). 2. What medications do you anticipate will be ordered and why would they be ordered? (What would be the goal of the medication)

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