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A nurse is preparing to care for a client on the medical unit.

Exhibits

Complete the following sentence by using the lists of options. The client is at risk for developing

as evidenced by the client's .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Correct answers:

1.    pulmonary edema

2.    shallow rapid breaths
 


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Related Questions

Correct Answer is D

Explanation

A. Heart rate elevation could indicate pain, but it's an objective sign rather than subjective. Pain should be assessed based on the client's self-report.
B. Guarding the abdominal incision is an objective sign of pain and discomfort but does not reflect the client's perception of pain.
C. Facial grimacing is an objective sign of pain but may not always correlate with the client's perception of pain.
D. The client's report of pain is a subjective indication that they are experiencing discomfort and need PRN pain medication. It is essential to address the client's self-reported pain to provide adequate relief and promote comfort and recovery.

Correct Answer is C

Explanation

Choice A Rationale: Puncturing the heel to a depth of 4 mm may be too deep and could cause injury to the newborn's foot. The recommended depth is usually less than 2 mm to avoid damaging underlying bone or tissues.
Choice B Rationale: Withholding feeding prior to collecting the specimen is not necessary and could cause unnecessary distress to the newborn. Feeding can help in soothing the infant and may even improve blood flow for the procedure.
Choice C Rationale: Applying a heat pack 5 to 10 minutes prior to the procedure is recommended as it helps to increase blood flow to the area, making the collection easier and potentially less painful for the newborn.
Choice D Rationale: Elevating the newborn's foot for 15 minutes following the procedure is not a standard recommendation. Post-procedure care typically involves applying gentle pressure to stop bleeding and then covering the puncture site with a bandage.

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