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1. A nurse is caring for a client in the emergency department (ED).

Nurses’ Notes

1500:

Client presents to the ED and reports dyspnea, and tachycardia. Client returned home from a vacation out of the country 24 hr ago.

 

1515:

The client has become diaphoretic, increasingly dyspneic, and is having a difficult time finding a position of comfort. The client states, “I feel like I’m going to die.” Crackles auscultated in bilateral lower lobes, S3 and S4 heart sounds noted.

 

Vital Signs

1500:

Temperature: 38.1° C (100.6° F)

Heart rate: 110/min

Respiratory rate: 24/min

BP: 138/52 mm Hg

Oxygen saturation: 92% oxygen at 0.5 L/min via nasal cannula

 

1515:

Temperature: 38.1° C (100.6° F)

Heart rate: 135/min

Respiratory rate: 32/min

BP: 120/50 mm Hg

Oxygen saturation: 90% on 1 L/min via nasal cannula

 

Complete the following sentence by using the list of options.

The nurse should first ____(A)_____ followed by _____(B)______

 

Word Choices:

(A)

place the client in tripod position

obtain a doppler ultrasound

administer an anticoagulant

obtain ABGS

 

(B)

placing the client on telemetry

initiating bleeding precautions

obtaining IV access

obtaining vital signs

 

2. A nurse is caring for a client who has stage I thyroid cancer. She began treatment with radiation therapy 5 days ago.

Nurses’ Notes

1300:

Client is accompanied by family member who reports client is experiencing generalized weakness and fatigue. She has had a very poor appetite and hasn’t been able to eat or drink anything all day. She also reports “feeling hot.” She has expressed to her family and friends that she feels that radiation therapy will not

help get rid of her cancer.

 

Vital Signs

1300:

Blood pressure 139/98 mm Hg

Temperature 102 ° F

Heart rate 108/min

Respiratory rate 20/min

 

Diagnostic Results

1300:

Glucose 73 mg/dL (74 to 106 mg/dL)

Calcium 10.5 mg/dL (9 to 10.5 mg/dL)

Sodium 135 mEq/L (136 to 145 mEq/L)

Potassium 3.5 mEq/L (3.5 to 5 mEq/L)

BUN 24 mg/dL (10 to 20 mg/dL)

Creatinine 0.9 mg/dL (0.5 to 1.0 mg/dL)

RBC count: 4.0 / uL ( 4.5 to 8 million / uL)

WBC count: 3000 / uL (3,200 to 10,000 / uL)

Platelet count: 25,000 (150,000 to 450,000 / uL)

 

Medical History

History of GERD, Anemia, Diabetes

 

Drag words from the choices below to fill in each blank in the following sentence:

 

After assessing the client and reviewing the client’s medical record, the nurse determines that the client is at highest risk for what?

The client is at high risk for _______________ and __________

 

Word Choices:

infection

hemorrhage

hyponatremia

hypoglycemia

SCIENCE
HEALTH SCIENCE
NURSING
NURS 5541

 

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