The nurse is caring for a client with pneumonia who now develops initial signs of septic shock and multi-organ failure. The healthcare provider prescribes a sepsis protocol. Which intervention is most important for the nurse to include in the plan of care?

A client's telemetry monitor indicates ventricular fibrillation (VF). Which action should the nurse implement immediately?

A nurse is planning care for a 10-year-old child who will be hospitalized for an extended period of time. Which of the following actions should the nurse include in the plan of care to meet the client's psychosocial needs according to Erikson?

A client with metastatic bone cancer is requesting pain medication. Which approach should the nurse use to assess the quality of the client's pain?

A client reports to the clinic nurse of recently experiencing symptoms of frequent urination, hunger, and great thirst. What finding (s) would the nurse consider as most significant to report to the healthcare provider? Select all that apply.

Reference Range

Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

Hemoglobin A1C [4% to 5.9%]

Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]

Total Cholesterol [less than 200 mg/dL (less than 5.2 mmol/L)]

What 2 orders should the nurse complete first?

A client is admitted for medical management of a bowel obstruction. The drainage volume from the nasogastric tube over the last 12 hours is 300 milliliters. Which assessment finding provides the earliest indication that the client is experiencing gastrointestinal motility?

Click to highlight the statement(s) made by the client that indicate she understood the treatment recommendations and is developing an understanding of her disease. Select all that apply.
1.    Working with an addiction therapist for several months will assist in my recovery.

2.    The Alcoholics Anonymous program would be a great resource, but they do not have meetings when I'm free.
3.    It is not safe for me to drink alcohol, but I am still able to smoke marijuana without problems.
4.    Identifying potential triggers allows me to proactively utilize coping strategies.

5.    Relapse is an expected complication of substance use; thus, prevention strategies and awareness of my emotions are important.
6.    The treatment options for alcoholism are limited to inpatients, with very few resources for outpatients.
 

Highlight findings that indicate the client is stable and ready to be discharged.

The client returned from appendectomy surgery last night at approximately 2100. The client was admitted for observation due to a delay in waking from anesthesia. The client is currently resting in bed. The incision dressing is dry and intact, and no bleeding is noted. The client tolerated clear liquids post recovery and has advanced to a soft diet. The client ambulated around the unit this morning and tolerated activity well. Bowel sounds are present in all 4 quadrants, and per client report, she has passed flatus. Pain is tolerated with analgesia PO.

Patient Data

Click to select the 5 most important nursing interventions for postoperative client care.

A client with an acute myocardial infarction (MI) is given a thrombolytic medication, aspirin, and IV heparin in the emergency department. Which finding indicates the client is having a satisfactory response?