The nurse notifies the healthcare provider of the client's status. The healthcare provider comes to the bedside to evaluate the client.
Which should the nurse do? Select all that apply.

Set up supplemental oxygen delivery

Suggest a different ventilator mode to the provider

Place a nasogastric tube

Increase the fraction of inspired oxygen

Set the ventilator to give mandatory breaths

Gather supplies for extubation

Answer and Explanation

Correct Answer : A,F

A. After successful weaning, the client will need supplemental oxygen via nasal cannula or face mask to ensure continued oxygenation post-extubation.

B. The current weaning process is progressing as expected with pressure support decreasing steadily. There is no indication that a different ventilator mode is necessary at this time.

C. There is no indication in the scenario that the client requires a nasogastric tube for ventilation weaning or extubation.

D. The fraction of inspired oxygen (FiO₂) is currently at 35%, which is appropriate during the weaning process. Increasing FiO₂ without indication could disrupt the weaning progression.

E. The weaning process is designed to gradually reduce support. Adding mandatory breaths would counteract the progress made in reducing ventilatory support.

F. The client has been weaned to minimal ventilatory support, which suggests the healthcare provider may plan for extubation. Having supplies ready will facilitate a smooth extubation process.

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Correct Answer is ["A","E"]

Explanation

A. A full pitcher of water poses a risk for fluid overload, which can exacerbate heart failure symptoms.

B. A saline lock is standard for potential IV access and does not require immediate intervention.

C. A low sodium diet is appropriate for heart failure management.

D. Having a bedside commode is helpful for the client’s comfort and safety.

E. The supine position can increase venous return and worsen heart failure symptoms; the client should be positioned upright to facilitate breathing.

A. Alert the emergency response team B. Insert straight catheter C. Count saturated pads per hour D. Administer 2 units of packed red blood cells (PRBC) E. Notify primary healthcare provider F. Increase the IV fluid to maximum rate G. Massage fundus until firm H. Administer 0.2 mg methylergonovine IM I. Weigh all bloody materials

Correct Answer is ["A","B","C","E","G"]

Explanation

A. The client is showing signs of significant hemorrhage, evidenced by the saturated pad and sheets. Immediate notification of the emergency response team is crucial for rapid intervention to address the potentially life-threatening situation.

B. The fundus was noted to be boggy and rotated to the right, which can indicate bladder distension affecting uterine tone. Catheterization can help relieve bladder pressure and promote uterine involution, reducing the risk of further bleeding.

C. Monitoring the amount of blood loss is essential to assess the severity of the hemorrhage. This information is critical for the healthcare provider to evaluate the need for further interventions, including possible blood transfusions.

D. While PRBC administration may be necessary later, the immediate intervention should focus on addressing the cause of the bleeding.

E. Given the client's condition, including the signs of significant bleeding and a boggy fundus, notifying the healthcare provider is essential for further assessment and intervention decisions. The provider may need to adjust treatment plans or order additional interventions promptly.

F. While fluid resuscitation is important, the focus should be on addressing uterine atony and monitoring bleeding first.

G. Fundal massage is a key intervention for addressing uterine atony. Firming the fundus can help control the bleeding by promoting uterine contractions, thereby decreasing the risk of postpartum hemorrhage.

H. Administer 0.2 mg methylergonovine IM: This medication is used for uterine atony, but it should only be given after assessing the client for contraindications (e.g., hypertension).

I. Weigh all bloody materials may be important for tracking blood loss, but immediate interventions should focus on controlling the bleeding first.

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The nurse notifies the healthcare provider of the client's status. The healthcare provider comes to the bedside to evaluate the client. Which should the nurse do? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A client is admitted with an exacerbation of heart failure secondary to chronic obstructive pulmonary disease (COPD). Which observation(s) by the nurse require immediate intervention to reduce the likelihood of harm to this client? Select all that apply.

Correct Answer is ["A","E"]

Explanation

Exhibits Based on the assessment data, the nurse recognizes the need to intervene immediately. Select the 5 priority interventions that the nurse should initiate based on the most recent assessment.

Correct Answer is ["A","B","C","E","G"]

Explanation

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The nurse notifies the healthcare provider of the client's status. The healthcare provider comes to the bedside to evaluate the client.
Which should the nurse do? Select all that apply.