ATI Comp Practice A WITH NGN 150 Q/A 2023/2024 A nurse on a medical-surgical unit is caring for a client who is postoperative following an emergency appendectomy. Vital Signs • Temperature 37.7° C (99.8° F)• Heart rate 82/min• Respiratory rate 16/min• Blood pressure 127/80 mm Hg��� ...
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A WITH NGN 150
Q/A 2023/2024 ATI Comp Practice A WITH
NGN 150 Q/A 2023/2024
A nurse on a medical-surgical unit is caring for a client who is p ostoperative following an emergency appendectomy.
Vital Signs
• Temperature 37.7° C (99.8° F)• Heart rate 82/min• Resp iratory rate 16/min• Blood pressure 127/80 mm Hg• Oxygen saturation 99% on roo m air
Assessment
Height 157.5 cm (62 in)Weight 90 kg (198 lb)Bilateral lower extremities warm to touch, pedal pulses 2+ bilaterally. Spider veins noted on bilater al lower extremities. Distended veins noted on right lower extremity .
Nurses' Notes
Client reports pain at abdominal incision site as 4 on a 0 to 10 scale.Client also reports right lower extremity pain as 5 on a 0 to 10 scale, and itching.Reports that
right lower extremity pain has been intermittent for about the last 2 months.Denies current left lower extremity pain. - ~ ANSWER Potential condition: varicose veins
Actions to take: apply compression stockings and elevate e xtremity
Parameters to monitor: Edema and pruritis of right lower ext remity
A nurse is caring for a preschooler on the pediatric unit.
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Day 1, 2350:Admit for observation.Obtain vital signs every 4 h r and PRN.Administer oxygen 2 L/min via nasal cannula to maintain oxy gen saturation above 95%.Initiate saline lock.Administer ceftriaxone 250 mg IV every 12 hr.Administer acetaminophen oral suspension 240 mg every 4 hr PRN for temperature greater than 38° C (100.4° F).Place on regu lar diet and encourage oral fluids of preschooler's choice.Monitor intake and outpu t every 8 hr.
Assessment
Day 2, 0030:Preschooler lying on bed, awake and alert. Breath sounds with wheezing auscultated on expiration on the right side. Nonprod uctive cough with no retractions or nasal flaring observed. Abdomen soft and no ndistended, bowel sounds active in all four quadrants. Preschooler reports he adache and pain in abdomen. Rates pain in abdomen as a 2 on a 0 to 10 FACES pain scale.
Vital Signs
Day 2, 0030:Temperature 38.1° C (100.6° F)Heart rate 12 2/minRespiratory rate 25/minOxygen saturation 98% on oxygen at 2 L/min via nasal cannulaWeig ht 17.3 kg (38 lb)Height 102.3 cm (40.3 in)
Nurses' Notes
Day 2, 0100:Saline lock inserted on first attempt. Assisted p reschooler to right side-lying position for splinting. Administered ceftriaxone IV. C aregiver at bedside.Day 2, 0130:Preschooler sitting up in bed, appearin g anxious and flushed. Lips swollen. Preschooler scratching hives that have appeared on both upper extremities.
History and Physical
2250:Admitted from the emergency department with a diagnos is of pneumonia on the right side with mild pleural effusion
Medical history: Preschooler has a history of asthma
Allergies: No known allergies - ~ ANSWER Administer epinephrine
IM.
Administer 0.9% sodium chloride IV.
Monitor vital signs frequently.
Discontinue the IV medication.Stuvia.com - The Marketplace to Buy and Sell your Study Material
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A nurse is caring for a client who is 24 hr postoperative fo llowing a cesarean birth.
History and Physical
Client is G2P2 at 38 weeks of gestation
Diagnosed with preeclampsia at 32 weeks of gestation
Scheduled repeat cesarean birth
Diagnosed with gestational diabetes mellitus at 29 weeks of gest ation
Nurses' Notes
1500:
Dressing dry and intact. Fundus firm midline at umbilicus. Scant lochia rubra. Client rates incisional pain as a 3 on a scale of 0 to 10, denies need for analgesia. Indwelling urinary catheter removed.1700:
Client reports headache with pain rated at 4 on a scale of 0 to 10. Analgesic administered.1800:
Client reports blurred vision and nausea. Rates pain from hea dache as a 6 on a scale of 0 to 10. Deep tendon reflexes 4+, clonus positive.
Vital Signs
1500:
Temperature 36.6° C (97.9° F)Heart rate 86/minRespiratory rate 18/minBlood pressure 155/90 mm HgOxygen saturation 98% on room air1800 :
Heart rate 96/minRespiratory rate 22/minBlood pressure 185/11 5 mm HgOxygen saturation 96% on room air
Laboratory Results
1700:
Capillary blood glucose (casual) 120 mg/dL (less than 200 mg/dL) WBC 22,000/mm3 (5,000 to 10,000/mm3) Hct 37% (greater than 33%) Hgb 12 g/dL (greater than 11 g/dL)Stuvia.com - The Marketplace to Buy and Sell your Study Material
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