A client has received spinal anesthesia. The nurse obtains a blood pressure reading of 72/56 mL/Hg. The nurse will
Continue to monitor blood pressure
Assess for headache
Administer oxygen by nasal cannula
Elevate the client's feet
The Correct Answer is A
Choice A rationale: A blood pressure reading of 72/56 mmHg may be expected after spinal anesthesia. The nurse should continue to monitor the blood pressure to ensure it stabilizes within an acceptable range for the individual patient.
Choice B rationale: Headache is a common side effect of spinal anesthesia, and the nurse should assess for this but should not be the first action with the given blood pressure reading.
Choice C rationale: Administering oxygen by nasal cannula may not be necessary based solely on the blood pressure reading after spinal anesthesia.
Choice D rationale: Elevating the client's feet is not the first intervention for a blood pressure reading of 72/56 mmHg after spinal anesthesia. It may be considered if the blood pressure remains low and symptoms of hypotension are present.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: Difficulty performing a voluntary movement, known as dyskinesia, is a potential side effect of Carbidopa-levodopa (Sinemet) used in Parkinson's Disease.
Choice B rationale: Increased blood pressure is not a typical side effect of Carbidopa-levodopa.
Choice C rationale: Increased constipation is not a typical side effect of Carbidopa- levodopa.
Choice D rationale: Itchiness of the skin is not a common side effect of Carbidopa- levodopa.
Correct Answer is D
Explanation
Choice A rationale: Adjusting the dose based on symptoms is not appropriate for phenytoin. It should be taken consistently as prescribed.
Choice B rationale: While taking phenytoin with meals is a general recommendation, it is not the priority teaching point.
Choice C rationale: Informing the patient about the prevention of gingival hyperplasia is important but not the top priority.
Choice D rationale: Teaching the patient to avoid the abrupt cessation of treatment is crucial. Abruptly stopping phenytoin can lead to seizures, and patients should be advised to taper the medication under medical supervision.
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