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ATI PROCTORED MEDSURGE EXAM

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A nurse is assessing a client who has cirrhosis. Which of the following findings is the priority for the nurse to report? P . 357 ch 55pdf Medsurg Platelets 70,000/mm3-risk of bleed normal range is 150,000 - 300,00- ABCS is compromised automatically. Distended abdomen-expected Alkalinephosphatase 125units/L -norm normal is 30 -120 D. Clay colored stools- bile not on yourshit A nurse is preparing to discontinuelong-termtotal parenteralnutrition (TPN) therapyfor a clientfor a client. The nurse should plan to discontinuethe TPNgradually to reduce the risk of which ofthe following adverse effects?Oldmed surge docs we used Hyperglycemia Diarrhea Constipation Hypoglycemia (Repeat) Sinceyourbody is producing enough insulin to take on higherloads,youmusttaperit down to avoid hypoglycemiawith lower concentrations of TPN Abruptly discontinuing TPN will cause reboundhypoglycemia A nurse is preparing to administer aunit of packed RBCsto a client. Which ofthe following actionsshould the nurse plan to take? P . 250 chapter 40 pdf p . 678 lewis Administerthe unit of packed RBC’s over1hr- 2- 4 hr itsmust be given for2 -4 hours. older adults Obtain the client’sfirstset of vitalsigns 1hr afterinitiating the transfusion-you get vitalsigns atthe initial first 15 to 30 minutes of the transfusion. Initiate venousaccess with a21-gauge needle - nomore than 19, for a regular adultitis 18 or 20 . Use Y tubingwith 0.9% sodiumchloride when administering the transfusion. Pg 249 TOXIC SHOCK SYNDROME-same A nurse is providing discharge teaching to an older adult clientwho had an exacerbation of COPD. The clientis to start fluticasonebymetered-doseinhaler. WHich ofthe following instructionsshould the nurse include? ( C) p . 132 ch 22 Use fluticasone as needed forshortness of breath.- fluticasoneusedto treatinflammation. Limitfluid intaketo 1L perday. - drink plenty to avoid dehydration. 2-3liters. Obtain a yearly influenza immunization. -reduce risk of infection. Assist use of pursed-lip breathing.-this is also one of the interventions the nurse does but the question ask aboutfluticasone. Itis a steroid, and we all know steroidsdecresaesinflammation but also depress our immunue system. So getting a flu shot is priority. A nurse is providing discharge teaching to an older adult clientfollowing a lefttotal hip arthroplasty. Which of the following instructionsshould the nurse include in the teaching? “You can cross yourlegs atthe ankles when sitting down.” -avoid flexion contraction “Clean the incisiondailywith hydrogenperoxide.”-soap and water “Install a raised toilet seat in your bathroom.” Pg 437 also use straight chairs with arms, abduction pillow betweenthe legs, avoidlow chairs, and flexion of hip greaterthan 90 degrees.NOcrossing legs, no turing on operative side. “You should use an incentive spirometer every 8hrs.”- once every hour atleast

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