Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness, recent K+ lvl is 3.4. What action would you do first?
a. emergent defib
b. amio 300mg IVP
c. emergent cardioversion
d. hang 10 mEq KCL/50mL D5W
C
The nurse notes the following when analyzing a patient's telemetry strip: HR, 65...
the nurse notes the following when analyzing a pat
a patient with chronic obstructive pulmonary disea
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Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness,
recent K+ lvl is 3.4. What action would you do first?
a. emergent defib
b. amio 300mg IVP
c. emergent cardioversion
d. hang 10 mEq KCL/50mL D5W
C
The nurse notes the following when analyzing a patient's telemetry
strip: HR, 65/min and regular; PR interval, 0.22 seconds; QRS complex,
0.10 seconds; QTc, 0.52 seconds. Which of the following dysrhythmias
is the patient at risk for?
A. Atrial fibrillation because the PR interval is wide
B. Sinus arrhythmia because the QRS complex is narrow
C. Torsades de pointes because the QTc is wide
D. Third-degree heart block because the PR interval is narrow
C.
QT measurements reflect the duration of ventricular repolarization.
Lengthening of QT interval is associated with arrhythmias, adverse
cardiac events, and increased mortality because a longer QT duration
places the vulnerable ventricular repolarization phase close to the
next depolarization, increasing the likelihood of R-on-T. The most
common arrhythmia that occurs with prolonged QTc is torsades de
pointes. Atrial fibrillation, sinus bradycardia, and third-degree
heart block are not typically associated with prolonged ventricular
repolarization (QTc >0.50 seconds).
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A patient with chronic obstructive pulmonary disease (COPD) is
admitted for worsening dyspnea and possible pneumonia. The current
ABG results are pH, 7.19; PaO2, 52 mm Hg; PaCO2, 68 mm Hg; HCO3 - ,
32 mmol/L. The nurse would interpret these results as
A. Metabolic acidosis with hypoxemia
B. Respiratory acidosis with hypoxemia
C. Respiratory alkalosis with typical oxygenation for a COPD patient
D. Metabolic alkalosis with typical oxygenation for a COPD patient
B.
, Based on the ABG analysis, the patient is experiencing a respiratory
acidosis with hypoxemia most likely due to the pneumonia. A pH of
7.19 indicates acidosis; a PaCO2 of 68 mm Hg is elevated and a cause
of acidosis; an HCO3 - of 32 mmol/L indicates renal compensation; a
PaO2 of 52 mm Hg indicates hypoxemia
76-year-old patient is receiving gentamicin and linezolid for an
infection. Which of the following potential complications is the most
important for the nurse to monitor this patient for?
A. Acute delirium
B. Acute kidney injury
C. Acute hepatic failure
D. Sepsis
B.
Gentamicin is a nephrotoxic agent that places patients at risk for
acute kidney injury, and this risk is increased in older patients.
Acute delirium (A), liver failure (C), and sepsis (D) are all
complications that could occur in an older adult with an infection
but would not be caused by the administration of an antibiotic.
An older patient is experiencing delirium 24 hours following hip
replacement. Which intervention might worsen the patient's condition?
A. Removing any unnecessary tubes and equipment from the room
B. Assessing and treating the patient's pain every 2 hours
C. Ensuring that the patient has the means to call for help
D. Loosely applying soft restraints
D.
Older patients are at increased risk for delirium during acute
hospitalization. Interventions to manage acute delirium include
removing or camouflaging tubes, removing unnecessary equipment,
frequently reorienting the patient, and ensuring that the call bell
is consistently within reach, assessing and treating pain effectively,
and encouraging mobility and involvement in activities of daily
living. Restraining the patient is contraindicated in the care of
patients with delirium.
A patient shows a new slight facial droop and the patient's right arm
is weaker than the left. A priority intervention would be to
A. Obtain a serum glucose level
B. Obtain a full set of vital signs
C. Initiate the stroke protocol
D. Initiate the code response team
C.
The stroke protocol should be activated as soon as signs of stroke
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