The nurse is admitting a client with COPD and respiratory acidosis. Which assessment finding would the nurse anticipate for this client?

a. Monitor blood glucose: Monitoring blood glucose levels may not be directly related to the procedure itself unless the client has a pre-existing condition such as diabetes mellitus. However, it is important to monitor for any changes in blood glucose levels post-procedure, especially if the client received medications such as intravenous dextrose during the procedure.

b. Neurovascular check of lower extremities: Assessing neurovascular status of the lower extremities is crucial after percutaneous coronary revascularization via the left groin site. This procedure involves accessing the femoral artery, which carries the risk of compromising blood flow to the lower extremity. Assessing for pulses, capillary refill, sensation, and motor function helps identify any potential complications such as bleeding, hematoma, or vascular compromise.

c. Check coagulation studies: Checking coagulation studies, such as activated partial thromboplastin time (aPTT) or prothrombin time (PT/INR), may be necessary after percutaneous coronary revascularization, especially if anticoagulant medications such as heparin were used during the procedure. Monitoring coagulation studies helps assess the client's risk of bleeding or thrombosis post-procedure.

d. Continuous ECG monitoring: Continuous electrocardiogram (ECG) monitoring is essential after percutaneous coronary revascularization to monitor for any changes in cardiac rhythm, ST-segment elevation or depression, and ischemic events. This helps identify any potential complications such as arrhythmias, myocardial infarction, or ischemia.

e. Verify contrast dye allergies: Verifying contrast dye allergies is important before performing any procedure involving the use of contrast media, such as percutaneous coronary revascularization. Allergic reactions to contrast dye can range from mild itching or rash to severe anaphylaxis. Identifying any allergies beforehand allows the healthcare team to take appropriate precautions and choose alternative imaging techniques if necessary.

a. Warm flushed extremities: In acute heart failure, there is typically inadequate cardiac output to perfuse the peripheral tissues adequately. This can lead to vasoconstriction and decreased blood flow to the extremities, resulting in cool and pale or mottled skin rather than warm flushed extremities.

b. Increased urine output: Acute heart failure is characterized by impaired cardiac function, which can lead to decreased cardiac output and reduced renal perfusion. This can result in decreased urine output rather than increased urine output. In acute heart failure, the kidneys may activate compensatory mechanisms such as the renin-angiotensin-aldosterone system, leading to sodium and water retention and decreased urine output.

c. Orthostatic hypotension: Orthostatic hypotension, a drop in blood pressure upon standing, is not typically associated with acute heart failure. Instead, acute heart failure is more commonly associated with signs and symptoms of fluid overload such as peripheral edema, pulmonary congestion, and jugular venous distension.

d. Decreased skin turgor: Decreased skin turgor is not a typical finding in acute heart failure. It is more commonly associated with dehydration or volume depletion rather than acute heart failure, which is characterized by fluid overload.