A nurse is assessing a client who has hypothermia. Which of the following findings should the nurse identify as a manifestation of hypothermia?

Impaired coordination

Sensitivity to light

Increased respiratory rate

Hypertension

Answer and Explanation

The Correct Answer is A

A) Impaired coordination:
Impaired coordination is a common manifestation of hypothermia. As the body temperature drops, the nervous system is affected, leading to difficulties in motor control and coordination. This symptom is indicative of the body's struggle to maintain normal physiological functions in response to the cold.

B) Sensitivity to light:
Sensitivity to light is not typically associated with hypothermia. This symptom is more commonly related to conditions affecting the eyes or the central nervous system, such as migraines or meningitis.

C) Increased respiratory rate:
Hypothermia generally leads to a decreased respiratory rate as the body's metabolic processes slow down. An increased respiratory rate is not a common symptom and may indicate another underlying condition or a compensatory mechanism for another issue.

D) Hypertension:
Hypertension is not a typical manifestation of hypothermia. In fact, as hypothermia progresses, the body's blood pressure often decreases due to reduced cardiac output and peripheral vasoconstriction.

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Correct Answer is ["A","C","E"]

Explanation

A) Headache:
Headache is a common adverse effect of albuterol due to its action on the central nervous system. The medication can cause vasodilation and changes in blood flow, leading to headaches. Parents should be aware of this potential side effect and manage it accordingly.

B) Hypotension:
Hypotension is not a typical adverse effect of albuterol. Albuterol primarily acts as a beta-2 agonist, leading to bronchodilation and some cardiovascular effects, but it generally does not cause a drop in blood pressure. Instead, it may occasionally increase blood pressure in some individuals.

C) Hyperactivity:
Hyperactivity is a known side effect of albuterol, especially in children. This occurs due to the stimulant effects of the medication on the central nervous system, leading to increased restlessness and activity levels. Parents should monitor their child's behavior for signs of increased hyperactivity.

D) Decreased pulse rate:
Decreased pulse rate (bradycardia) is not associated with albuterol use. Albuterol tends to cause tachycardia, an increased heart rate, due to its beta-adrenergic stimulating effects. Monitoring the pulse rate is essential, but a decreased rate is not a typical concern with this medication.

E) Tremors:
Tremors are a common adverse effect of albuterol, resulting from the stimulation of beta-adrenergic receptors in the muscles. This can cause muscle shaking or jitteriness, particularly in the hands. Parents should be informed about this possible side effect and observe their child for signs of tremors.

A. Check skin temperature distal to the injury with the dorsum of the hand. B. Press the heel of the foot to determine capillary refill. C. Monitor sensation by palpating the pad of the great toe with a blunt needle. D. Compare the color of the skin proximal to the injury with the other extremity.

Correct Answer is A

Explanation

A. Check skin temperature distal to the injury with the dorsum of the hand.: Assessing skin temperature distal to the injury is an important part of evaluating neurovascular status. It helps to identify any changes in circulation or potential complications like ischemia. The dorsum of the hand is commonly used as it provides a good comparison to the temperature of the affected extremity.

B. Press the heel of the foot to determine capillary refill.: While capillary refill is an important assessment, it is usually measured by pressing the nail beds or pads of the fingers and toes, not by pressing the heel. This method does not provide a reliable indication of neurovascular status.

C. Monitor sensation by palpating the pad of the great toe with a blunt needle.: While assessing sensation is important, it is typically done using a light touch or pinprick, rather than palpating with a blunt needle. The use of a needle is not standard practice for this type of assessment.

D. Compare the color of the skin proximal to the injury with the other extremity.: Comparing the skin color distal to the injury with the unaffected extremity is more relevant for evaluating neurovascular status. Proximal comparison is less effective in assessing circulation and potential issues related to the injury.

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A nurse is assessing a client who has hypothermia. Which of the following findings should the nurse identify as a manifestation of hypothermia?

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Naxlex Comprehensive Predictor Exams

A nurse is providing teaching about albuterol to a parent of a school-age child who has asthma. The nurse should instruct the parent to monitor for which of the following findings as adverse effects of albuterol? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

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Correct Answer is A

Explanation

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