A nurse is completing an 8-hr 1&O record for a client who consumed 4 oz juice, 6 oz tea, a 100 mL cup full of ice chips, an IV bolus of 150 mL, and 8 oz broth. The nurse should record how many mL of intake on the client's record?
The Correct Answer is ["732"]
To calculate the total intake, we need to convert all measurements to the same unit, in this case, milliliters (mL).
1 ounce (oz) is approximately equal to 29.5735 mL.
Also, it’s important to note that when ice chips melt, they become about half their volume in water. So, 100 mL of ice chips would become about 50 mL of wate
Let’s calculate:
Juice: 4 oz * 29.5735 = 118.294 mL
Tea: 6 oz * 29.5735 = 177.441 mL
Ice chips: 100 mL * 0.5 = 50 mL
IV bolus: 150 mL
Broth: 8 oz * 29.5735 = 236.588 mL
Adding all these together:
118.294 mL (juice) + 177.441 mL (tea) + 50 mL (ice chips) + 150 mL (IV bolus) + 236.588 mL (broth) = 732.323 mL
So, the nurse should record 732 mL of intake on the client’s record (rounded to the nearest whole number).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) A client who is scheduled for discharge following a laparoscopic tubal ligation:
While it's important to attend to clients scheduled for discharge, they are typically stable and do not have immediate care needs. This client can be seen after addressing more acute care needs.
B) A client who experienced a cesarean birth 4 hr ago and reports pain:
This client requires immediate attention. Post-cesarean pain management is crucial for comfort and early mobilization. Addressing the client's pain is a priority to ensure their well-being and promote recovery.
C) A client who has preeclampsia with a BP of 138/90 mm Hg:
While preeclampsia is a serious condition, a blood pressure of 138/90 mm Hg is within the borderline range for hypertension in pregnancy. It does not represent an immediate threat compared to the post-cesarean client who reports pain.
D) A client who experienced a vaginal birth 24 hr ago and reports no bleeding:
This client, who reports no bleeding after a vaginal birth, is stable and can be seen after addressing the immediate needs of the post-cesarean client who is experiencing pain.
Correct Answer is D
Explanation
A. Contractions lasting longer than 90 seconds: Prolonged contractions lasting longer than 90 seconds may indicate uterine hyperstimulation, which can compromise fetal oxygenation and lead to fetal distress. This finding should be reported to the provider promptly for further evaluation and management.
B. Client reports feeling contractions in the lower back: This is a common sensation during labor and may not necessarily indicate a complication. However, if associated with other signs of fetal distress, it should be reported.
C. Contractions occurring every 3 to 5 minutes: This frequency is within the normal range for the active phase of labor and does not necessarily indicate a problem. However, it is essential to consider the duration and intensity of contractions along with this frequency.
D. Contractions are strong in intensity: While strong contractions are typical during the active phase of labor, the intensity alone may not be a cause for concern unless they are associated with uterine hyperstimulation.
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