While the pandemic rages on, there are some interesting positive changes

Question Answered step-by-step Compare and contrast the various ways you can access information deliveringprofessional continuing education. Explore any relationships between technology and learning and evaluate which works best for you. Health Science Science Nursing NURSING 538 Share QuestionEmailCopy link Comments (0)

QuestionClinical Hint: Clients going to surgery are at high risk for...Clinical Hint: Clients going to surgery are at high risk for injury. The preoperative nurse preparing the client needs to be sure all aspects of care have been analyzed before the surgery begins. The nurse reviews A. M.'s laboratory results. Laboratory Report Normal 1/1/22 1/2/22WBC 4,000-11,000 uL 9,000 15,000Hemoglobin 12.0-17.0 g/dL 11.0 6.9Hematocrit 36.0-51.0% 35 28RBC 4.2-5.9 cells/L 3.8 2.5Platelets 150,000-350,000 uL 145,000 102,000Calcium 9-10.5 g/dL 8.8 8.7Chloride 98-106 mEq/L 99 98 Laboratory Report Normal 1/1/22 1/2/22Magnesium 1.5-2.4 mEq/L 2.1 1.9Phosphorus 3.0-4.5 mg/dL 3.1 3.0Potassium 3.5-5.0 mEq/L 3.2 3.3Sodium 136-145 mEq/L 142 144Glucose 70-199 mg/dL 189 267BUN 8-20 mg/dL 39 25Creatinine 0.7-1.3 mg/dL 1.3 1.2CPK 30-170 U/L 422 304LDH 60-100 U/L 154 279AST 0-35 U/L 34 33ALT 0-35 U/L 30 32GGT 9-48 U/L 42 36T. Bilirubin 1.2 mg/dL 0.9 1.0Cholesterol <200 mg/dL 259 246Triglycerides <150 mg/dL 198 188 Which laboratory results should the nurse bring to the attention of the healthcare provider prior to surgery? Select all that apply.White blood cellsHgb & HctCalciumPotassiumGlucoseCholesterol/Triglycerides Which additional lab(s) is/are concerning and should be reported to the surgeon prior to surgery?Red blood cellsPlatelet countCreatinine level Liver enzymes After alerting the surgeon of the lab reports, the surgery is postponed. Intravenous antibiotics are started, potassium is replaced, and the client receives 1 unit of packed red blood cells. Because of poor venous access, a peripherally inserted central catheter (PICC) is placed in the left basilic vein. Additionally, A.M. is started on short-acting insulin to control the blood glucose levels. The next day, 1/3/22, she shows improvement and is taken to surgery for an Open Reduction Internal Fixation of the Left hip. A.M. is now 24 hours postoperative. The nurse reviews her electronic vital sign record. Day Time BP HR RR O2 Sats Temp Pain1/2/22 1310 110/75 105 14 99%O2 2L 100.7 2/10 2050 108/67 100 16 96%O2 1L 99.0 3/101/3/22 0030 145/88 110 22 95% RA 7/10 0200 127/78 88 16 94% RA 97.2 4/10 0815 100/76 90 18 95% RA 3/10 1635 110/72 92 22 94% RA 98 8/10 1905 115/70 88 20 94% RA 100.0 5/10 2200 110/75 86 18 95% RA 97.0 2/101/4/22 0800 118/75 98 20 95% RA 98 4/10 1620 98/56 110 22 92% RA 100.5 6/10 2110 89/50 114 24 95%O2 1L 101.2 5/10 After analyzing the vital sign trends, what information is most concerning to the nurse?Respirations of 14 on 1/2/22BP 145/88 at 0030 on 1/3/22BP 89/50 at 2110 on 1/4/22Temp 101.2 at 2110 on 1/4/22 Based on this information, what should be the nurse's priority action?Increase O2 for respirations of 14 on 1/2/22Administer pain medication for BP at 0030 on 1/3/22Increase IV fluids for BP at 2110 on 1/4/22Deliver acetaminophen for fever at 2110 on 1/4/22 At 1620 on 1/4/22, there is a change in the client's condition. What action(s) should the nurse take? Select all that apply.Deliver pain medication with close monitoringStop IV fluidsApply OxygenPlace a cool cloth on the client's foreheadEncourage coughing and deep breathingHave the client walk in the hall At 2110 on 1/4/22, the nurse decides to contact the provider for additional orders. What additional assessment information should the nurse collect in preparation for the SBAR communication. The nurse notes that there are two providers following A.M. Which provider should the nurse contact first?Dr. BaldwinDr. Schoenberg The nurse communicates with the provider.S- Hi Dr._________, this is the nurse caring for A.M. at JFKUMC. I'm calling because her BP is low at 89/50 mmHg and temperature is up to 101.2.B- She came in on 1/1/22 after falling and fracturing her hip. She returned from surgery 24 hours ago. She has a history of rheumatoid arthritis and takes prednisone daily. She also had an elevated WBC count prior to surgery and has been receiving cefazolin IV.A-Her wound site is slightly reddened with clear, serous drainage, the staples are intact. Her lungs are diminished in the bases, and she has been placed on O2 1L to maintain her saturations at 95%. WBC's are at 13,000. The indwelling catheter is draining concentrated, cloudy urine. Her PICC catheter dressing is intact with an antimicrobial patch covering the insertion site. Based upon the SBA(R) communication, what assessment findings indicate the most likely site(s) of infection? Select all that apply. WoundLungsBloodUrinePICC catheterHealth ScienceScienceNursingNURSING N221Share Question

Question Answered step-by-step 1. What are Rosa's risk factors for developing pre-eclampsia?2. Why did the nurse ask Rosa about headaches, blurred vision, and RUQ pain?3. What signs and symptoms prompted Rosa's physician to consult with the maternal-fetal specialist and arrange for a transfer to a tertiary care center? Using this information:Rosa Garcia is a 25-year-old married Mexican immigrant who is pregnant with her first child. Rosa's family practice physician has been caring for her since her first prenatal visit at 114/7 weeks' gestation. During the initial prenatal visit, the following data were obtained:Vital signs: temperature: 98.6°F (37.0°C); pulse: 78 beats/min; respirations: 20 breaths/min; blood pressure: 110/70; weight: 146 lb (66.4 kg)A complete physical examination was performed with normal findings, and prenatal labs including a thyroid-stimulating hormone level (TSH; because of a positive family history for hypothyroidism) were drawn. During the interview, the nurse inquired about any other family medical problems. Rosa reported that both her sister and her mother had experienced pre-eclampsia during pregnancy.An ultrasound was ordered for pregnancy dating because Rosa had experienced irregular menstrual periods since discontinuing oral contraceptives.Rosa kept her regular prenatal appointments every 4 weeks and the pregnancy progressed uneventfully until 4 months later, when she presented to the office with increased blood pressure and swollen legs. Rosa had noticed an increased swelling that extended up to the knees of both legs. She denied hand or facial swelling, headaches, visual problems, or RUQ pain. Her sister, a chiropractor, had been checking her blood pressure and noted it to be as high as 160 to 170/100 to 110 mm Hg. At this prenatal visit, the following data were obtained:Blood pressure: 144/96 (sitting). Repeat on left side: 140/90. Weight: 172.5 lb (78.4 kg)Urine dipstick reading: 1 +Physical examination: General—in no acute distress; abdomen: nontender fundus at 28-11.8 in. (30 cm) above the symphysis pubis; FHR 150 bpm; cardiovascular: 1 + pedal edema; neurological: reflexes 3 + with no clonus.Assessment: Pre-eclampsia without severe features.The following laboratory tests were ordered: CBC with platelet count, liver enzyme determination (AST, ALT, LDH), alkaline phosphatase (ALP), prothrombin time (PT), a chemistry panel (electrolytes: Na+, K+, Cl-, HCO3-, Ca2+, Mg2+), blood urea nitrogen (BUN), creatinine (Cr), uric acid, and a 24-hour urine collection for protein and creatinine clearance. A sonogram (ultrasound) was also ordered to monitor the status of the fetus.Rosa was instructed to go home, rest on her left side as much as possible, and call the nurse if she experienced increased edema, headaches, visual disturbances, or RUQ pain. She was told to continue with fetal kick counts and twice daily blood pressure monitoring, record all findings and symptoms, and return to the office in 1 week.On her next office visit 8 days later, Rosa reported that she had been adhering to frequent rest periods at home and had noticed that her leg edema was improved. She exclaimed: "I can see my ankle bones again!" Her sister had continued to monitor the blood pressure. According to the blood pressure log, Rosa's systolic blood pressure measurements had been in the 160s and the diastolic measurements were in the 80 to 90 range. Rosa denied headaches, visual disturbances, or abdominal pain and remarked that the fetus had been active. At this visit, the following data were obtained:Blood pressure: 160/98 (sitting); 162/100 (left side); weight: 160 lb (72.7 kg); fundal height: 27 cm; FHR: 150 to 170 bpm; reflexes: 3 to 4 + with no clonus; urinary protein: 4 + (2,000 + mg/dL) on dipstickAssessment: Pre-eclampsia with severe features at 294/7 weeks' gestational ageAt this point, Rosa's physician consulted with a maternal fetal medicine specialist, who advised transferring Rosa to a tertiary care center 50 miles away. Rosa was promptly transferred to the tertiary care center and admitted to the obstetric service. Health Science Science Nursing NURS 4131 Share QuestionEmailCopy link Comments (0)

While the pandemic rages on, there are some interesting positive changes

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