Patient Data ​​​​​​

Exhibits

At 2000, the unlicensed assistive personnel (UAP) reported the client's vital signs as a temperature of 102.1° F (38.9° C) orally, a heart rate of 62 beats/minute, respirations of 19 breaths/minute, and a blood pressure of 124/68 mm Hg.

Which action(s) should the nurse take? Select all that apply

Patient Data

Click to highlight the notes that demonstrate a positive outcome.

The client is admitted to the hospital after her membranes rupture at 38 weeks gestation. A vaginal examination is done. The nurse determines that the client is 3 cm dilated, 40% effaced, and the fetal head is at -1 station. The external monitor snows that contractions are occurring every 4 minutes and lasting 70 seconds, and the nurse palpates the quality as strong. Her fasting blood glucose (FSBG) is 86 (4.8 mmol/L).

The client is transferred to the labor- delivery-recovery (LDR) suite. The client dilates quickly to 10 cm and feels a strong urge to push. The fetal heart rate is reassuring with a baseline of 145 and moderate variability. The nurse briefly reviews pushing techniques with her and her husband and notifies the obstetrician of the client's progress. After three cycles of open-glottis pushing, the baby's head is crowning. The head is born easily over an intact perineum. The infant weighs 9 lbs. 9 oz (4.34 kgs) and has an Apgar of 7 at 1 minute, then 9 at 5 minutes.

The healthcare provider prescribes amoxicillin 5 grams PO daily, in equally divided doses to be administered every 8 hours. The medication is available in a bottle labeled, "Amoxicillin suspension 200 mg/5 mL."

How many mL should the nurse administer every 8 hours?

(Enter numeric value only. If rounding is required, round to the nearest tenth.)

A client with advanced cirrhosis is being treated for hepatic encephalopathy. In reviewing the client's serum laboratory results, which finding requires the most immediate intervention by the nurse?

The nurse completes auscultation of the heart on an older adult client. Which finding is considered normal for this client?

Patient Data

The nurse reviews the prescriptions and assessment data.

Click to indicate which interventions could help reduce symptoms if added to the plan of care. Each row must have one response option selected.

Patient Data

The nurse is reviewing nurses' notes to determine if there are any variations. Click to highlight the findings that would indicate the client has developed a complication related to pregnancy.

The client is a 32-year-old multigravida at 28 weeks' gestation, who presents to the obstetrician's office for a routine prenatal visit. Obstetrical history reveals she has given birth three times; once at 35 weeks (twins), once at 38 weeks (singleton) and once at 41 weeks (singleton). All of these children are alive and well. She had one spontaneous abortion at 10 weeks' gestation. Her fourth child weighed 9 pounds (4.08

Kg) at 41 weeks gestation.

Client is at 28 weeks. She has been receiving prenatal care since 8 weeks' gestation. Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L). Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 (9.3 mmol/L) and a two-hour postprandial of 220 mg/dL (12.2 mmol/L).