A nurse is preparing a client for a hip arthroplasty. For which of the following reasons should the nurse assess the client's vital signs?

To determine how the client will tolerate the procedure

To establish a baseline for postoperative assessment

To prevent postoperative hypotension

To assess the client's pain level

Answer and Explanation

The Correct Answer is B

A.   Vital signs, including blood pressure, heart rate, respiratory rate, and temperature, provide baseline information about the client's cardiovascular and respiratory status. This assessment helps predict how well the client might tolerate the surgical procedure under anesthesia and monitor for any deviations during the procedure.
B.   Establishing baseline vital signs before surgery provides a comparison point for monitoring the client's recovery and identifying any postoperative complications. Changes in vital signs postoperatively can indicate potential issues such as bleeding, fluid imbalance, or respiratory compromise.
C.   Monitoring blood pressure before surgery helps identify clients at risk for intraoperative hypotension, particularly important during induction of anesthesia and throughout the surgical procedure. Establishing baseline blood pressure levels guides intraoperative management to maintain hemodynamic stability.
D.   While vital signs are important for assessing physiological status, they do not directly assess pain. Pain assessment involves asking the client about their pain experience, location, intensity, and factors that alleviate or exacerbate pain. Vital signs can indirectly reflect pain if pain causes changes in heart rate or blood pressure, but they are not specific indicators of pain.

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Free Nursing Study Resources

Correct Answer is ["28"]

Explanation

(Volume in mL * Drop Factor) / Time in minutes.

Volume is 1,000 mL, the drop factor is 10 gtt/mL, and the time is 6 hours.

First, convert the hours into minutes (6 hours * 60 minutes/hour = 360 minutes). Then, multiply the volume by the drop factor (1,000 mL * 10 gtt/mL = 10,000 gtt).

Finally, divide this number by the total time in minutes (10,000 gtt / 360 minutes ≈ 27.78

gtt/min).

Rounding to the nearest whole number, the nurse should set the manual IV infusion to deliver 28 gtt/min.

A. Apply a warm compress to the IV site. B. Apply firm pressure to the plunger of the syringe during the IV flush to improve patency. C. Remove the IV saline lock. D. Inject the solution more slowly while flushing the IV saline lock

Correct Answer is D

Explanation

A. Applying a warm compress can help dilate the blood vessels, potentially improving circulation around the IV site. This can sometimes alleviate discomfort caused by irritation or infiltration. However, if there is significant pain or swelling, warm compresses may not be sufficient.
B. Applying firm pressure on the syringe plunger during the flush is not recommended. Excessive force could potentially cause damage to the vein or exacerbate pain and discomfort. It's important to flush gently to maintain patency and avoid causing further irritation or complications.
C. If the client reports pain above the IV saline lock and there are signs of infiltration (such as swelling, coolness, or blanching of the skin around the site), removing the IV saline lock may be necessary. Infiltration occurs when IV fluid leaks into the surrounding tissue instead of flowing into the vein, which can lead to discomfort and complications.
D. Injecting the solution more slowly during the flush can help minimize discomfort and reduce the risk of causing further damage. Slower infusion allows for better tolerance by the vein and surrounding tissues, decreasing the likelihood of pain or infiltration.

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A nurse is preparing a client for a hip arthroplasty. For which of the following reasons should the nurse assess the client's vital signs?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["28"]

Explanation

A nurse is attempting to flush the IV saline lock for a client. The client reports pain above se should monitor the client for whic: flush. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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