A client is being transferred to the medical-surgical unit from the PACU after receiving general anesthesia for a procedure. Which of the following actions is the priority for the nurse when the client arrives on the unit?
Assess airway patency
Check the dressing to assess bleeding.
Check tubes or drains for patency.
Assess all vital signs.
The Correct Answer is A
A. Assess airway patency: Ensuring the airway is patent is the highest priority because compromised airway patency can lead to life-threatening respiratory complications. This is the first step in the ABCs (Airway, Breathing, Circulation) of emergency and postoperative care.
B. Check the dressing to assess bleeding: While assessing the dressing for bleeding is important, it is secondary to ensuring the client has a patent airway. Uncontrolled bleeding can be addressed after confirming the client can breathe adequately.
C. Check tubes or drains for patency: Checking tubes and drains for patency is also important, but it should be done after ensuring the client's airway is secure. This step is essential for preventing complications but is not as immediately critical as airway assessment.
D. Assess all vital signs: Assessing vital signs is crucial, but it follows after ensuring airway patency. Vital signs provide comprehensive information about the client's status, but an obstructed airway must be addressed first to ensure effective breathing and oxygenation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Imitation of the lining of the stomach: This is not a common complication related to calcium supplementation or fluid intake.
B. Mobilization of calcium from bones: Drinking fluids does not affect the mobilization of calcium from bones; this is more related to bone health and calcium metabolism.
C. Developing kidney stones: Adequate fluid intake helps prevent kidney stones, which can form when there is excess calcium in the urine. High calcium levels can lead to stone formation if not properly managed with sufficient hydration.
D. Developing muscle cramps: While calcium plays a role in muscle function, fluid intake primarily helps with kidney function and preventing stone formation rather than directly preventing muscle cramps.
Correct Answer is A
Explanation
A. Kayexalate (sodium polystyrene): This is the correct choice. Kayexalate is used to treat hyperkalemia (high serum potassium levels) by facilitating the removal of excess potassium from the body through the gastrointestinal tract.
B. Potassium chloride: This is used to treat hypokalemia (low potassium levels), not hyperkalemia.
C. Sodium bicarbonate: This can be used to correct metabolic acidosis and may indirectly help with potassium levels, but it is not the primary treatment for hyperkalemia.
D. Aldactone (spironolactone): This is a potassium-sparing diuretic that can increase potassium levels, which would be contraindicated in the case of hyperkalemia.
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