The client hospitalized with infective endocarditis develops sharp flank pain and hematuria. The nurse notifies the physician, recognizing that these clinical manifestations may indicate:

vegetative embolization to the kidneys.

hemolysis of red blood cells by hemolytic microorganisms.

septicemia resulting in decreased glomerular blood flow.

bacterial infection in the kidneys.

Answer and Explanation

The Correct Answer is A

A. vegetative embolization to the kidneys: Infective endocarditis is an infection of the heart valves or the endocardium. Vegetations (clumps of bacteria, fibrin, and platelets) can form on the damaged heart structures. These vegetations are fragile and can break off, forming emboli that travel through the bloodstream to various organs. Embolization to the kidneys can cause renal infarction, leading to sharp flank pain due to ischemia or infarction of kidney tissue and hematuria.

B. hemolysis of red blood cells by hemolytic microorganisms: While some bacteria can cause hemolysis, it is not typically associated with localized flank pain. Hemolysis would present with systemic signs such as jaundice, fatigue, and anemia, not acute flank pain and visible hematuria.

C. septicemia resulting in decreased glomerular blood flow: Septicemia may impair renal perfusion over time but would more likely lead to generalized signs of acute kidney injury, such as oliguria and rising creatinine levels, rather than acute flank pain and hematuria.

D. bacterial infection in the kidneys: Acute pyelonephritis can cause flank pain and hematuria, but in the context of infective endocarditis, embolic events are a more likely and urgent explanation for new-onset symptoms, particularly sharp localized pain.

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Free Nursing Study Resources

Correct Answer is ["125"]

Explanation

Calculate the total volume to be infused in drops.

Total drops = Total volume (mL) × Drop factor (gtts/mL)

= 1000 mL × 60 gtts/mL

= 60000 gtts

Calculate the total infusion time in minutes.

Total infusion time (minutes) = Total hours × 60 minutes/hour

= 8 hours × 60 minutes/hour

= 480 minutes

Calculate the IV flow rate in drops per minute (gtts/min).

IV rate (gtts/min) = Total drops / Total infusion time (minutes)

= 60000 gtts / 480 minutes

= 125

=125 gtts/min

A. Administer amiodarone IV push followed by a continuous infusion. B. Establish unresponsiveness and check the carotid pulse. C. Immediately defibrillate the client using the synchronous mode. D. Initiate a rapid response call and increase the monitor's sensitivity.

Correct Answer is B

Explanation

A. Administer amiodarone IV push followed by a continuous infusion: Amiodarone is part of the Advanced Cardiac Life Support (ACLS) algorithm for ventricular fibrillation (VF) or pulseless ventricular tachycardia, but it should only be given after confirming the rhythm and initiating basic life support steps, including pulse check.

B. Establish unresponsiveness and check the carotid pulse: The rhythm strip shows ventricular fibrillation, a life-threatening arrhythmia. However, before initiating advanced interventions such as defibrillation, the nurse must first confirm the client is unresponsive and pulseless, which is the correct initial action according to ACLS protocols.

C. Immediately defibrillate the client using the synchronous mode: Defibrillation is the correct treatment for VF, but it must be done in unsynchronized mode. Additionally, it is not appropriate to defibrillate until pulselessness is confirmed. Synchronized mode is used for rhythms like unstable SVT or atrial fibrillation not VF.

D. Initiate a rapid response call and increase the monitor’s sensitivity: A rapid response team is called for deteriorating patients who are still responsive. If the client is unresponsive and pulseless, a code blue or cardiac arrest protocol should be initiated, not just a rapid response. Monitor sensitivity adjustments are irrelevant in a confirmed life-threatening rhythm.

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Potassium 2.8 mEq/L
Sodium 133 mEq/L
Chloride 90 mEq/L
Glucose 200 mg/dl
Magnesium 2.5 mg/dL
Calcium 8.0 mg/dL

The client hospitalized with infective endocarditis develops sharp flank pain and hematuria. The nurse notifies the physician, recognizing that these clinical manifestations may indicate:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is to receive LR 1000 ml over 8 hours. The IV tubing drop rate is 60 gtts/ml. What is the correct rate (gtts/min)? DOCUMENT ANSWER AS: RATE gtts/min (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["125"]

Explanation

The nurse observes the following rhythm of a client on the telemetry unit. Which action should be completed first?

Correct Answer is B

Explanation

The nurse is caring for a client diagnosed with acute decompensated heart failure. The client is increasingly anxious and restless. The nurse should plan to implement which prescribed orders to assist in relieving these symptoms?

A client is prescribed oral amiodarone for recurrent ventricular dysrhythmias. The nurse should teach the client to notify the physician if which symptom develops?

Which physical assessment findings would the nurse anticipate for a client with rapid atrial flutter?

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The nurse is caring for a client with suspected infectious endocarditis. Which information obtained in the health history could contribute to the development of this problem?

A client is to receive an intravenous dose of adenosine. What immediate response to this medication should the nurse expect?

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