A nurse assesses a postoperative patient 2 days after chest surgery. What four findings indicate that the patient has inadequate pain control?
Bradypnea
Irritability
Tachycardia
Hypoglycemia
Poor cough effort
Drowsiness
Refusal to participate in physical therapy
Correct Answer : B,C,E,G
Choice A: Bradypnea
Bradypnea, or slow breathing, is not typically associated with inadequate pain control. It is more often related to the effects of certain medications, such as opioids, or underlying respiratory conditions. Inadequate pain control is more likely to cause increased respiratory rate (tachypnea) rather than decreased.
Choice B: Irritability
This is a correct answer. Irritability can be a sign of inadequate pain control. Pain can cause significant discomfort and distress, leading to changes in mood and behavior. Patients who are in pain may become irritable, anxious, or agitated.
Choice C: Tachycardia
This is another correct answer. Tachycardia, or an increased heart rate, can be a physiological response to pain. When a patient is in pain, the body’s stress response is activated, leading to the release of stress hormones like adrenaline, which can increase heart rate.
Choice D: Hypoglycemia
Hypoglycemia, or low blood sugar, is not directly related to pain control. It is more commonly associated with diabetes management, fasting, or certain medications. While it is important to monitor blood sugar levels, hypoglycemia is not a typical indicator of inadequate pain control.
Choice E: Poor cough effort
This is a correct answer. Poor cough effort can indicate inadequate pain control, especially after chest surgery. Pain can make it difficult for patients to take deep breaths or cough effectively, which is essential for preventing respiratory complications such as pneumonia.
Choice F: Drowsiness
Drowsiness is not typically a sign of inadequate pain control. It is more often a side effect of pain medications, particularly opioids. While it is important to monitor for excessive sedation, drowsiness alone does not indicate that pain is not being adequately managed.
Choice G: Refusal to participate in physical therapy
This is the final correct answer. Refusal to participate in physical therapy can be a sign of inadequate pain control. Pain can make movement and physical activity difficult and uncomfortable, leading patients to avoid necessary rehabilitation exercises. Effective pain management is crucial for encouraging participation in physical therapy and promoting recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is True
Explanation
Choice A: True
The statement that a patient with alkalosis can develop hyperkalemia is generally incorrect. Alkalosis, which is a condition characterized by a higher-than-normal pH in the blood, typically leads to hypokalemia rather than hyperkalemia. This occurs because alkalosis causes potassium to shift from the extracellular fluid into the cells, reducing the plasma potassium concentration. Therefore, it is uncommon for alkalosis to result in hyperkalemia.
Choice B: False
The correct answer is that a patient with alkalosis is unlikely to develop hyperkalemia. Alkalosis usually causes a decrease in plasma potassium levels, leading to hypokalemia. This is due to the movement of potassium ions into the cells in exchange for hydrogen ions, which are moved out of the cells to help buffer the increased pH. Consequently, the plasma potassium concentration drops, making hyperkalemia an unlikely outcome in the presence of alkalosis.
Correct Answer is ["B","C"]
Explanation
Choice A: Hyponatremia - Dehydration
Hyponatremia occurs when the sodium levels in the blood are abnormally low. While dehydration can contribute to hyponatremia, it is not the most common cause. Hyponatremia is more frequently caused by conditions that lead to an excess of water in the body, diluting the sodium levels. These conditions include heart failure, kidney disease, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Choice B: Hypomagnesemia - Chronic alcoholism
This is a correct pairing. Hypomagnesemia, or low magnesium levels in the blood, is often associated with chronic alcoholism. Alcoholism can lead to poor dietary intake of magnesium, increased urinary excretion of magnesium, and gastrointestinal losses due to vomiting and diarrhea. These factors contribute to the development of hypomagnesemia in individuals with chronic alcoholism.
Choice C: Hyperkalemia - Kidney failure
This is also a correct pairing. Hyperkalemia, or high potassium levels in the blood, is commonly caused by kidney failure. The kidneys are responsible for excreting excess potassium from the body. When the kidneys are not functioning properly, they cannot remove potassium efficiently, leading to its accumulation in the blood. Other causes of hyperkalemia include certain medications, such as potassium-sparing diuretics, and conditions that cause cellular breakdown, such as rhabdomyolysis.
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