The nurse is caring for a client with a heart rate of 48. His blood pressure is 120/80. Which finding will help the nurse determine the cause of the client's bradycardia?

The client has a fever.

The client has possible hemorrhage or bleeding.

The client has chronic obstructive pulmonary disease (COPD).

The client has calcium channel blocker medicate prescribed.

Answer and Explanation

The Correct Answer is D

A.   Fever can cause tachycardia (increased heart rate) rather than bradycardia. It is not typically associated with slowing of the heart rate unless there are other complicating factors such as severe infection or medication side effects.
B.   Significant blood loss can lead to hypovolemia (low blood volume), which can result in bradycardia as a compensatory mechanism to maintain blood pressure. However, the blood pressure in this scenario is

normal (120/80), which makes severe hemorrhage less likely unless compensated by fluid resuscitation or other factors.
C.   COPD can cause chronic hypoxia and respiratory acidosis, which can lead to chronic respiratory compensation and potentially bradycardia. However, COPD alone is less likely to cause bradycardia in the absence of severe exacerbation or other complicating factors.
D.   Calcium channel blockers (CCBs) are medications commonly prescribed for conditions such as hypertension, angina, and arrhythmias. They work by blocking calcium channels in cardiac and smooth muscle cells, resulting in decreased heart rate and vasodilation. Bradycardia is a known side effect of CCBs, especially when taken in excess or in combination with other medications that affect heart rate.

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Correct Answer is D

Explanation

A. Encouraging adequate fluid intake is important postoperatively to maintain hydration and support normal physiological functions. However, the amount of fluid intake should be within the client's tolerance and as prescribed by the healthcare provider. It helps prevent complications such as dehydration and promotes circulation, which is beneficial for wound healing.

B. While some rest and limited mobility are initially recommended after knee replacement surgery to allow for healing and to prevent complications, prolonged bed rest for 5-7 days is not typically necessary or recommended. Early mobilization and gradual increase in activity are encouraged to prevent complications such as deep vein thrombosis and to promote recovery.
C. Placing a pillow directly under the knee is not recommended as it can lead to decreased range of motion and potential contractures.
D. Cold therapy, such as applying cool compresses, is often used to reduce swelling and pain in the initial postoperative period. It can help manage pain and discomfort and promote comfort for the client.

A. Metabolic alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Respiratory alkalosis

Correct Answer is B

Explanation

A. Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate (HCO3-). The ABG results show a pH of 7.32 (which is acidic), PaCO2 of 48 mm Hg (slightly elevated), and HCO3- of 23 mEq/L (within normal range). These findings do not indicate metabolic alkalosis.
B. Respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2 (>45 mm Hg). The ABG results show a pH of 7.32 (acidic) and a PaCO2 of 48 mm Hg (slightly elevated). These findings are consistent with respiratory acidosis, where the elevated PaCO2 indicates inadequate ventilation leading to retention of carbon dioxide and subsequent acidosis.

C. Metabolic acidosis is characterized by a low pH (<7.35) and a decreased bicarbonate (HCO3-). The ABG results show a pH of 7.32 (acidic) and HCO3- of 23 mEq/L (normal). These findings are not indicative of metabolic acidosis.
D. Respiratory alkalosis is characterized by a high pH (>7.45) and a decreased PaCO2 (<35 mm Hg). The ABG results show a pH of 7.32 (acidic) and a PaCO2 of 48 mm Hg (elevated). These findings do not indicate respiratory alkalosis.

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The nurse is caring for a client with a heart rate of 48. His blood pressure is 120/80. Which finding will help the nurse determine the cause of the client's bradycardia?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client 8 hr postoperative following a total knee replacement. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO2 48 mm Hg and the HCO3 is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances?

Correct Answer is B

Explanation

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