The nurse is caring for a client who just had a subclavian central venous catheter inserted. Which symptom should the nurse recognize as setting a priority for this client's care?
Decreased pedal pulses
Tachycardia
Presence of bibasilar crackles
Headache
The Correct Answer is B
B. Tachycardia (elevated heart rate) can be a sign of various underlying conditions, including pain, anxiety, or cardiovascular compromise. While tachycardia may occur as a response to stress or pain associated with the catheter insertion procedure, it can also indicate complications such as hemorrhage, cardiac dysrhythmias, or pulmonary embolism, which require prompt evaluation and intervention.
A. While this can be concerning, it is not typically directly related to complications of a subclavian central venous catheter insertion unless there is evidence of arterial injury or thrombosis.
C. Bibasilar crackles are abnormal lung sounds that can indicate fluid accumulation in the lungs, such as pulmonary edema or pneumonia. However, this may not be directly related to the subclavian central venous catheter insertion itself.
D. Headache is a non-specific symptom that can have numerous causes, including stress, dehydration, or tension.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
C. Sleep plays a crucial role in stress management and resilience. Adequate sleep helps regulate stress hormones such as cortisol, promotes emotional regulation, and enhances coping mechanisms. Chronic sleep deprivation can lead to increased stress levels and reduced ability to cope with stressors.
D. Sleep is essential for the restoration and repair of both the mind and body. During sleep, the body undergoes processes such as tissue repair, muscle growth, and memory consolidation. Sleep also allows the brain to clear toxins and waste products accumulated during wakefulness, promoting cognitive function and overall well-being.
E. One of the functions of sleep is to conserve energy. During sleep, metabolic rate and energy expenditure decrease, allowing the body to conserve resources for essential physiological processes. Sleep helps replenish energy stores, repair cellular damage, and prepare the body for the next day's activities.
A. Sleep has been shown to have analgesic effects and can improve pain tolerance. Adequate sleep helps reduce the perception of pain and promotes the release of endogenous pain-relieving substances in the body.
B. During sleep, blood pressure typically decreases as part of the normal sleep-wake cycle. However, certain sleep disorders, such as sleep apnea, may lead to fluctuations in blood pressure during sleep. Overall, quality sleep is important for maintaining cardiovascular health and regulating blood pressure.
Correct Answer is ["A","C","E"]
Explanation
A. Assessing family members for potential poor bereavement outcomes, such as complicated grief or unresolved issues, allows the nurse to provide appropriate support and interventions. This may involve identifying risk factors, offering counseling or referrals to support services, and providing emotional support to family members as needed.
C. Assessing the understanding of the dying process among family members helps the nurse identify their informational needs, address misconceptions, and provide education and support accordingly. Clear communication and open dialogue can help alleviate anxiety and uncertainty and empower family members to participate actively in the care of their loved one.
E. Respecting and supporting the client's religious and cultural beliefs and practices is essential in providing culturally competent care. This may involve collaborating with spiritual or religious leaders, facilitating rituals or ceremonies, providing appropriate accommodations, and honoring the client's preferences regarding end-of-life care and decision-making.
B. Encouraging frequent meals may not be appropriate during the dying process, as the client's appetite and ability to eat may be significantly diminished. Instead, the focus should be on providing comfort measures, maintaining oral hygiene, and offering small, manageable amounts of food or fluids based on the client's preferences and comfort level.
D. Urging the family to limit their time with the client is contrary to supporting them during the dying process. Family presence and involvement are essential for providing emotional support, companionship, and comfort to the client. Encouraging meaningful interactions and opportunities for sharing memories and expressions of love can promote a sense of connection and closure for both the client and their family.
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