A nurse is managing a patient's fluids and outputs over a shift. Here are the details:
- 0700: The nurse starts an IV of 0.45% Normal saline infusing at 100 mL/hr.
- 0900: The patient has coffee-ground emesis (vomit) measuring 300 mL.
- 1000: The nurse stops the IV of 0.45% Normal saline to administer an IV antibiotic. The antibiotic administered is Kefzol 1 g in 25 mL of D5W over 30 minutes.
- 1030: The antibiotic infusion stops, and the nurse resumes the IV fluid of 0.45% Normal saline at 100 mL/hr.
- 1100: The physician orders the insertion of an NG tube and intermittent suction. The nurse inserts the NG tube and connects it to intermittent suction.
- 1530: The patient voids another 350 mL and 200 mL. The nurse checks the NG tube canister and records the output for the shift as 300 mL.
Calculate the patient's total intake from 0700 to 1530.
The Correct Answer is ["725"]
-
IV Fluid Intake:
- From 0700 to 0900: 2 hours × 100 mL/hr = 200 mL
- From 1030 to 1530: 5 hours × 100 mL/hr = 500 mL
- Total IV Fluid Intake: 200 mL + 500 mL = 700 mL
-
Antibiotic Infusion Intake:
- Antibiotic Solution: 25 mL
-
Total Intake Calculation:
- IV Fluid Intake: 700 mL
- Antibiotic Infusion: 25 mL
- Total Intake: 700 mL + 25 mL = 725 mL
Answer: The total intake for the patient from 0700 to 1530 is 725 mL.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D, Jell-O, broth, apple juice. A clear liquid diet consists of fluids and foods that are clear and liquid at room temperature. These foods are easy to digest and leave no residue in the gastrointestinal tract. Examples include water, clear fruit juices, clear broths, tea, coffee without cream, and Jell-O.
Correct Answer is A
Explanation
A pureed diet is a type of texture-modified diet where food is blended to a smooth consistency to make it easier to swallow. Nectar-thick liquids are liquids that have a slightly thicker consistency than water, which makes them easier for the client to swallow without choking or aspirating.
Options B, C, and D are not appropriate for a client with dysphagia on a pureed diet with nectar-thick liquids. Corn on the cob is a hard, crunchy food that is difficult to puree, while a hamburger and a salad are both difficult to make into a smooth consistency. These foods could pose a choking or aspiration risk for the client.
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