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A nurse is assessing a client who is 48 hr postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

A.

Yellow-green drainage on the surgical incision

B.

Blood pressure 102/66 mm Hg

C.

Straw colored urine from an indwelling urinary catheter

D.

Respiratory rate 18/min

Answer and Explanation

The Correct Answer is A

Yellow-green drainage from a surgical incision may indicate the presence of infection, especially if the drainage is purulent. This finding should be reported to the provider promptly for further evaluation and management to prevent complications such as wound infection or dehiscence.

A. Yellow-green drainage on the surgical incision: Yellow-green drainage suggests the presence of infection, which is a concerning finding in a postoperative client. It may indicate purulent drainage, which requires further assessment and possibly treatment with antibiotics.
B. Blood pressure 102/66 mm Hg: A blood pressure of 102/66 mm Hg is within the normal range for an adult client and does not typically require immediate intervention. However, trends in blood pressure should be monitored, especially if the client is symptomatic or if there are significant changes from the client's baseline.
C. Straw-colored urine from an indwelling urinary catheter: Straw-colored urine is a normal finding and indicates adequate hydration and kidney function. As long as the urine output is adequate and there are no other signs of urinary tract issues, this finding does not typically require immediate reporting.
D. Respiratory rate 18/min: A respiratory rate of 18 breaths per minute is within the normal range for an adult client and does not typically require immediate intervention. However, it's important to assess the client's respiratory status comprehensively, including oxygen saturation and lung sounds, to ensure adequate ventilation.
 


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Related Questions

Correct Answer is D

Explanation

A. Battery involves the unauthorized or harmful touching of another person without their consent. Restraint without proper justification could potentially lead to a charge of battery, but the situation described does not involve actual physical contact.
B. Assault involves the threat of bodily harm to another person, creating fear or apprehension that the harm will be carried out. While the threat of restraint might cause fear, actual restraint is necessary to constitute assault.
C. Invasion of privacy refers to the unauthorized intrusion into an individual's private affairs or the public disclosure of private information. It does not apply to the act of physically restraining a client.
D. False imprisonment occurs when an individual is unlawfully restrained or confined against their will. In this scenario, the provider's directive to restrain the client against her wishes constitutes false imprisonment if the restraint is not justified by the client's medical condition or pose an immediate danger to herself or others.

Correct Answer is ["0.5"]

Explanation

Let's convert the digoxin dosage from mcg (micrograms) to mg (milligrams) and then divide it by the amount of digoxin per tablet to find out how many tablets are needed.

Steps to solve:

  1. Convert digoxin dose from mcg to mg:
    • We know 1 mg is equal to 1000 mcg.
    • Digoxin dose (mg) = Digoxin dose (mcg) / 1000 mcg/mg
    • Digoxin dose (mg) = 125 mcg / 1000 mcg/mg
    • Digoxin dose (mg) = 0.125 mg
  2. Calculate the number of tablets required:
    • Number of tablets = Digoxin dose (mg) / Digoxin per tablet (mg)
    • Number of tablets = 0.125 mg / 0.25 mg/tablet

Since the result is 0.5, we need to round to the nearest tenth.

Answer: The nurse should administer 0.5 tablets per dose.

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