A 68-year-old woman has recently undergone cardiac surgery for repair of a defective heart valve. She has a midline chest incision. The registered nurse identifies a patient problem of inadequate oxygenation related to general anesthesia and pain. What nursing interventions would be appropriate for this patient to meet the goals of adequate oxygenation for this patient problem?
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- A 55-year-old patient presents to the emergency department with acute shortness of breath, wheezing, and coughing. The patient has a history of chronic obstructive pulmonary disease (COPD) and reports not having used their prescribed inhaler as regularly as advised. Which of the following actions is the priority for the nurse to take?A) Instruct the patient to resume regular use of their inhaler as prescribed.B) Administer oxygen therapy and prepare to administer bronchodilators as prescribed.C) Educate the patient about the importance of quitting smoking immediately.D) Schedule the patient for a pulmonary function test (PFT) to reassess their COPD.A post-op client is receiving morphine sulfate (Duramorph®) for pain. Upon assessment, the nurse notes that the client's respiratory rate is very slow and that there is a slight bluish discoloration around the lips. The nurse immediately prepares to administer which of the following? O Flumazenil (Romazicon) naloxone (Narcan) Activated Charcoal acetylcysteineA client came to the emergency department with complaints of weakness, difficulty in breathing, productive cough, and pain in the chest. On interviewing the client, the nurse finds that the client is an industrial worker with expose to asbestos. His family health history shows two deaths due to lung cancer. Discuss critically what should the nurse emphasize during the physical examination of this client.
- A client who is scheduled for a bronchoscopy in the morning is anxious and asking the nurse numerous questions about the procedure. In preparing the client for the procedure, which intervention has the highest priority? Allow client to gargle with warm salt water. Administer a sedative to alleviate anxiety. Instruct client to write down the questions. Deny client's request for a midnight snack.A patient admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2 L/ minute via nasal prongs. The patient’s history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD), because of these history findings ,the Nurse closely monitors the oxygen flow and the patient's respiratory status Explain the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD) Which complication may arise if the patient receives a high oxygen concentration? List two (2) nursing Interventions with rationales for this patient mark for each nursing intervention 2 marks for each rationaleThe client’s laboratory report today indicates severe hypokalemia, and the nurse has notified the provider. Nursing assessment indicates that heart rhythm is regular when looking at the telemetry monitor. What is the priority nursing intervention? Would it be initiating fall precautions due to potential postural hypotension and weak leg muscles, establish seizure precautions due to potential muscle twitching, cramps, and seizures, or examine sacral area and patient’s heels for skin breakdown due to potential edema. Which one is the priority of these three options
- Scenario Description: Juan Ferguson 50-year-old man with long-term emphysema who has become dyspneic and has been brought to the Emergency Department by paramedics and now is admitted to your floor for admission. He arrives alert and anxious, wheezing and still dyspneic. An IV has been started. Oxygen is started. What is my client’s primary and possible secondary diagnosis? What signs and symptoms would I expect to see with primary and secondary diagnosis? What do I need to assess? What is my top three priority assessments for this client? (Airway, breathing, circulation) What is my focused assessment for this patient and any nursing interventions I may need? What are the signs/symptoms that my client may exhibit if their condition is worsening? Give one or two reasons you would want to contact the healthcare provider?Scenario: Emily Campbell is a 48 year old female, she came to the Emergency Department with chest pain and some shortness of breath. She was conscious and ambulatory, and was accompanied by her 19 year old daugter. Presenting complaint: "Nurse, I just don't feel quite right. I've had pain on my chest and I've been feeling breathless." Question(s): 1.) What type of health history should the nurse be taking for Ms. Campbell? Elaborate why. 2.) What three vital questions do you need to ask in order to explore Ms. Campbell's symptoms? Explain the significance of each. 3.) Which part of the history assesment tool should you give focus on with regards to Ms. Campbell's case? Give at least 3 and explain.A 68-year-old patient has been brought back to the surgical unit following a below-the-knee amputation for complications associated with peripheral vascular disease. What are the most common postoperative complications in a patient with an amputation? What nursing interventions would be indicated in the immediate postoperative period?
- Case A comatose patient had formerly expressed a desire to have her respirator turned off if she ever required one. Her parents do not want to turn it off, but her husband does. The parents present their arguments to the administrator, chief of the medical staff, and director of nursing. Answer the following questions in a 2-3 page response: What are the legal facts of the case? What is the ethical dilemma? What standard of care is required? What are the risks to the healthcare organization if turning off the respirator? If not turning off the respirator? What options does the healthcare organization have to resolve this dilemma? What precautions should healthcare organizations take to prevent this type of ethical dilemma in the future?A 72-year-old male patient with a history of atrial fibrillation and controlled hypertension has been initiated on warfarin therapy. Upon assessment of the patient’s history, it was revealed that he has a history of peptic ulcer. This patient also has a recent history of a peptic ulcer. Given the client’s medical history and current medication regimen, which of the following instructions should the nurse prioritize when providing discharge teaching? A. Report incidents of diarrheaB. Avoid foods high in vitamin K C. Use a straight razor when shaving D. Take aspirin for pain relief E. Monitor for signs of bleeding, such as bruising or black tarry stools F. Check blood pressure regularly at home G. Inform all healthcare providers about the anticoagulant therapyA nurse is caring for a client who presented to the emergency department with an acute asthma exacerbation. The respiratory rate is 36 breaths/min, and a pulse oximeter is 85% on room air with accessory muscle use to breathe. The nurse placed the client on oxygen 4 liters nasal cannula. The arterial blood gas (ABG) is as follows: pH: 7.28, PaCO2: 50 mm Hg, PaO2: 75 mm Hg, and HCO3: 26 mEq/L. Which of the following treatments is the nurse's highest priority? A) Administer bronchodilators B) Administer sodium bicarbonate Administer methylprednisolone (D) Perform a chest x-ray