A client with pancreatic cancer develops ascites, and 2 liters of fluid are removed via paracentesis. Which schedule should the nurse implement to assess the client's blood pressure after this procedure?
Every 5 minutes for 30 minutes, then every 4 hours thereafter.
Every 5 minutes for one hour.
Every 15 minutes for one hour, then every 1 hour for 2 hours.
Every 1 hour for 2 hours.
The Correct Answer is A
A. Every 5 minutes for 30 minutes is crucial after paracentesis to closely monitor for signs of hypovolemia, such as a sudden drop in blood pressure. After this initial intensive monitoring period, the frequency can be reduced to every 4 hours to assess for any delayed effects or complications.
B. Every 5 minutes for one hour is a shorter duration of monitoring compared to option A and
may not provide adequate time to detect and respond to any significant changes in blood pressure that could occur after paracentesis, especially considering the volume of fluid removed.
C. Every 15 minutes for one hour, then every 1 hour for 2 hours provides frequent monitoring
initially, but the interval between assessments is too long after the first hour, potentially missing early signs of complications such as hypovolemia.
D. Every 1 hour for 2 hours does not provide sufficient frequency of monitoring, especially during the critical immediate post-paracentesis period when rapid changes in blood pressure can occur. This schedule may delay the detection and management of complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
- A: Providing a list of alternative activities may reduce fatigue, but it does not consider the child's interest in swimming, which can be therapeutic and enjoyable for children with Duchenne muscular dystrophy.
- B: While team sports can be good for socialization, they may not be suitable for a child with Duchenne muscular dystrophy due to the progressive muscle weakness associated with the condition, which could lead to increased risk of injury.
- C: At the age of 6, children are capable of understanding basic risks, and it is important to communicate with them appropriately rather than assuming they are too young. Moreover, swimming can be adapted to be safe for children with physical limitations.
- D: Swimming is an excellent activity for children with Duchenne muscular dystrophy because it is low-impact and can help maintain muscle strength and function. With proper supervision and precautions, the risks can be managed, making it a suitable activity for the child to continue.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E","dropdown-group-3":"A"}
Explanation
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Dyspnea: Dyspnea, or difficulty breathing, can be a symptom of an adverse reaction such as an allergic reaction, anaphylaxis, or cardiovascular issues. It indicates a severe reaction that affects the respiratory system and requires immediate attention.
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Nausea: Nausea is a common symptom of adverse reactions to medications or other substances. It can accompany other symptoms like dizziness or headache and indicates that the client is experiencing an ongoing negative reaction to a treatment or exposure.
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Headache: A headache can be a manifestation of various adverse reactions, including those related to medication or changes in blood pressure. It is a significant symptom that may indicate worsening of the client's condition or an ongoing adverse reaction that needs to be addressed.
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