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A client who is postoperative is receiving IV fluids and a unit of whole blood.
The nurse should observe the client for which of the following as an early sign of circulatory overload?

Bradycardia.

Dyspnea.

Flushing.

Vomiting.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Bradycardia, or a slow heart rate, is not typically an early sign of circulatory overload.

Choice B rationale:

Dyspnea, or difficulty breathing, is an early sign of circulatory overload. This occurs because the heart is unable to pump the excess blood effectively, leading to fluid buildup in the lungs.

Choice C rationale:

Flushing, or reddening of the skin, is not typically an early sign of circulatory overload.

Choice D rationale:

Vomiting is not typically an early sign of circulatory overload.

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Correct Answer is B

Explanation

Choice A rationale:

Scrambled eggs are soft and easy to chew and swallow, making them appropriate for a mechanically altered diet.

Choice B rationale:

Wheat toast is hard and requires more chewing, which may be difficult for a client on a mechanically altered diet.

Choice C rationale:

Cottage cheese is soft and easy to chew and swallow, making it appropriate for a mechanically altered diet.

Choice D rationale:

A sliced banana is soft and easy to chew and swallow, making it appropriate for a mechanically altered diet.

A. Repeat the potassium level. B. Withhold the medication. C. Monitor for paresthesia. D. Administer a hypertonic solution.

Correct Answer is B

Explanation

Choice A rationale:

Repeating the potassium level is not the first action to take. The nurse already has a recent lab value.

Choice B rationale:

The nurse should withhold the medication. The normal range for potassium is 3.5-5.0 mEq/L. A level of 5.5 mEq/L is high, so giving more potassium could lead to hyperkalemia.

Choice C rationale:

Monitoring for paresthesia is important in hyperkalemia, but it is not the first action. The nurse should first prevent further increase in potassium levels.

Choice D rationale:

Administering a hypertonic solution is not relevant in this situation. It does not directly address the high potassium level.

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A client who is postoperative is receiving IV fluids and a unit of whole blood. The nurse should observe the client for which of the following as an early sign of circulatory overload?

Nursing Test Bank

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A client who is postoperative is receiving IV fluids and a unit of whole blood.
The nurse should observe the client for which of the following as an early sign of circulatory overload?