The nurse is caring for a postpartum client who is receiving pain medication through an epidural catheter. Which assessment finding should the nurse report immediately to the physician?
Blood pressure: 120/80.
Pain rating of 4 on a scale of 1 to 10.
Pulse rate: 80.
Respiratory rate: 8.
The Correct Answer is D
The nurse should immediately report a respiratory rate of 8 to the physician. A normal respiratory rate for an adult is between 12 and 20 breaths per minute. A respiratory rate of 8 is considered abnormally low and can indicate respiratory depression, which can be a side effect of pain medication delivered through an epidural catheter. It is important for the nurse to report this finding immediately so that appropriate interventions can be taken to ensure the safety of the client.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
In this situation, the nurse demonstrated integrity. After realizing the mistake of giving a client who was NPO a morning breakfast tray, the nurse took responsibility for the mistake by notifying the physician and the client, explaining the consequences of the mistake, and documenting the situation in the client's medical record. The other options (Altruism, Human dignity, and Social justice) are not directly related to this situation.
Correct Answer is D
Explanation
When collecting equipment to administer a unit of packed red blood cells, the nurse should use 250 mL of normal saline to initiate the IV for this transfusion ³. Normal saline is the only compatible solution to use with blood or blood components ³. The other options (100 mL of 5% dextrose and 1/2 normal saline, 1,000 mL of lactated Ringer's solution, and 500 mL of 5% dextrose and water) are not appropriate IV fluids to use when administering a unit of packed red blood cells.

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