A nurse is assessing a client who is 4 hr postoperative following arterial revascularization of the left femoral artery. Which of the following findings should the nurse report to the provider immediately?

Temperature of 37.9° C (100.2° F)

Urine output 150 mL over 4 hr

Bruising around the incisional site

Pallor in the affected extremity

Answer and Explanation

The Correct Answer is D

A) Temperature of 37.9° C (100.2° F): A slight elevation in temperature can be common after surgery and may not indicate a serious issue. It should be monitored, but it is not immediately concerning.

B) Urine output 150 mL over 4 hr: While urine output is an important indicator of kidney function and overall perfusion, this output may still be acceptable depending on the client's overall fluid status and other factors. It does not necessarily require immediate reporting unless there are other concerning symptoms.

C) Bruising around the incisional site: Some bruising can be expected after surgery, particularly with arterial procedures. It should be monitored, but unless there are signs of excessive bleeding or hematoma formation, it is not typically an urgent concern.

D) Pallor in the affected extremity: This finding is critical and should be reported immediately. Pallor could indicate compromised blood flow to the extremity, which could be a sign of complications such as graft occlusion or inadequate perfusion. Prompt intervention may be necessary to prevent serious complications or tissue loss.

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Correct Answer is D

Explanation

A) Heart rate 60/min: A heart rate of 60 beats per minute is on the lower end of the normal range. While bradycardia can be concerning, it does not indicate the need for an increase in dopamine dosage specifically. The primary goal of dopamine administration in hypovolemic shock is to improve perfusion and blood pressure, rather than solely addressing heart rate.
B) Respiratory rate 14/min: A respiratory rate of 14 breaths per minute is within the normal range for adults. This finding suggests that the client is not experiencing respiratory distress and does not warrant an increase in the dopamine dosage. The focus should be on hemodynamic parameters rather than respiratory rate in this context.
C) Oxygen saturation 95%: An oxygen saturation of 95% is considered acceptable and indicates adequate oxygenation. While maintaining oxygen saturation is important, this finding does not directly reflect the effectiveness of dopamine in improving hemodynamics. Therefore, it does not indicate the need for a dosage increase.
D) Blood pressure 90/50 mm Hg: A blood pressure reading of 90/50 mm Hg indicates hypotension and poor perfusion, which is a significant concern in a client with hypovolemic shock. An increase in dopamine dosage is warranted in this situation, as dopamine is administered to enhance cardiac output and improve blood pressure. Therefore, this finding strongly indicates the need to adjust the medication to ensure adequate hemodynamic support.

A. Diuretic B. Anticonvulsant C. Opioid analgesic D. Antithrombotic

Correct Answer is D

Explanation

A) Diuretic: Diuretics are not typically indicated following an ischemic stroke unless there are specific comorbid conditions, such as heart failure or hypertension, that warrant their use. They do not address the primary needs of stroke management.

B) Anticonvulsant: While some stroke patients may require anticonvulsants if they experience seizures, this is not a standard therapy for all ischemic stroke patients upon discharge. The primary focus after an ischemic stroke is often on preventing future strokes rather than seizure control.

C) Opioid analgesic: Opioids are generally not indicated for stroke management and are not a standard part of discharge therapy. Pain management is important, but other medications are prioritized for stroke prevention and rehabilitation.

D) Antithrombotic: Antithrombotic therapy, which includes antiplatelet agents (like aspirin) or anticoagulants, is crucial for preventing further ischemic events. This type of pharmacologic therapy is typically prescribed for patients post-ischemic stroke to reduce the risk of subsequent strokes.

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A nurse is assessing a client who is 4 hr postoperative following arterial revascularization of the left femoral artery. Which of the following findings should the nurse report to the provider immediately?

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Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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