A patient, age 23, underwent a rhinoplasty 6 hours ago. After administering his pain medication, the nurse notes that he is swallowing frequently. What is the most likely cause of the swallowing?

Bleeding posterior to the nasal packing.

Oral dryness caused by nasal packing.

An adverse reaction to the analgesic.

A normal response to the analgesic and surgery.

Answer and Explanation

The Correct Answer is B

Rhinoplasty is a surgical procedure performed on the nose, and it often involves the placement of nasal packing to control bleeding, support the nasal structures, and promote healing. Nasal packing can cause mouth breathing and oral dryness, which can lead to increased swallowing as the patient tries to alleviate the discomfort.

While bleeding posterior to the nasal packing is a potential complication of rhinoplasty, it typically presents with other symptoms such as active bleeding, nasal discharge, or changes in vital signs. Without additional information or signs of active bleeding, it is less likely to be the cause of the patient's frequent swallowing in this scenario.

An adverse reaction to the analgesic is possible, but it would typically present with other symptoms such as allergic reactions (rash, swelling, difficulty breathing) or gastrointestinal symptoms (nausea, vomiting). In the absence of these symptoms, an adverse reaction to the analgesic is less likely.

Lastly, a normal response to the analgesic and surgery would not typically manifest as frequent swallowing. While pain medication can cause side effects, such as drowsiness or nausea, increased swallowing is not a common response.

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Correct Answer is C

Explanation

The pH value of 7.5 indicates alkalosis, as it is above the normal range of 7.35-7.45. The elevated bicarbonate (HCO3-) level of 34 mmol/L suggests metabolic alkalosis, as it is higher than the normal range of 22-28 mmol/L. The PaCO2 level of 40 mm Hg falls within the normal range of 35-45 mm Hg.

In this case, the primary disturbance is metabolic alkalosis, which is likely caused by the persistent vomiting leading to excessive loss of gastric acid (hydrogen ions) and chloride ions from the stomach. This loss of acid and chloride results in an imbalance of electrolytes and an increase in bicarbonate levels, leading to metabolic alkalosis.

Since there is no significant deviation from the normal range in the PaCO2 level, the respiratory system has not effectively compensated for the metabolic alkalosis. Therefore, it is considered uncompensated.

A. Oxygen Stats B. Pulse rate and Rhythm C. Respiratory rate and depth D. Deep tendon reflexes

Correct Answer is B

Explanation

An increased serum potassium level, also known as hyperkalemia, can have adverse effects on the electrical conduction of the heart, potentially leading to life-threatening cardiac dysrhythmias. Therefore, it is crucial to assess the patient's pulse rate and rhythm promptly to identify any abnormal cardiac activity.

Assessing the oxygen saturation (oxygen stats), respiratory rate and depth, and deep tendon reflexes are also important assessments, but they are not the priority in this case. Hyperkalemia primarily affects cardiac function, and prompt identification of any potential cardiac rhythm disturbances is essential to prevent further harm.

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A patient, age 23, underwent a rhinoplasty 6 hours ago. After administering his pain medication, the nurse notes that he is swallowing frequently. What is the most likely cause of the swallowing?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

In reviewing the electrolytes of a patient, the nurse notes the serum potassium level has increased from 4.3 mEq/L to 5.9 mEq/L. Which assessment does the nurse initiate first to prevent further harm?

Correct Answer is B

Explanation

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