A nurse is caring for a client who is dehydrated and receiving IV fluid replacement. The nurse should identify that which of the following findings indicates the treatment has been effective?
Increased heart rate
Excessive thirst
Moist oral mucous membranes
Decreased blood pressure
The Correct Answer is C
A. An increased heart rate can be a sign of dehydration and would not indicate that IV fluid replacement has been effective.
B. Excessive thirst is a symptom of dehydration and would not indicate that IV fluid replacement has been effective.
C. Moist oral mucous membranes indicate improved hydration status and are a positive response to IV fluid replacement.
D. Decreased blood pressure is a sign of dehydration and would not indicate that IV fluid replacement has been effective.
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Related Questions
Correct Answer is D
Explanation
A. This statment appeasr to challenge the patient's autonomy hence it is not appropriate.
B. This response may induce fear or guilt in the client, which is not conducive to addressing the underlying reasons for medication refusal.
C. This response may minimize the client's concerns and does not address the root cause of their refusal.
D. It is important to notify the provider so that additional interventions can be sought
Correct Answer is D
Explanation
A. The client has a history of anaphylaxis following a bee sting: This finding is not directly related to the safety of taking alendronate for osteoporosis.
B. The client has a first-degree relative who has Paget's disease: While family history is
important in assessing the risk of osteoporosis, it is not a direct safety risk for taking alendronate.
C. The client is postmenopausal: Postmenopausal status is a common indication for the use of alendronate to prevent or treat osteoporosis. It is not a safety risk.
D. The client has immobility that restricts her to a supine position: Immobility, especially in a supine position, can increase the risk of esophageal irritation and reflux when taking alendronate. Therefore, this finding poses a safety risk for the client when taking this medication.
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