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The nurse is continuing to assist in the care of the client.
Exhibits
The nurse should anticipate a provider prescription for and

Answer and Explanation

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

1. Bumetanide 1 mg IV stat: The client’s vital signs show hypotension (blood pressure 88/54 mm Hg) and tachycardia (heart rate 104/min). The skin is cool and moist, and capillary refill is delayed, suggesting possible fluid overload or heart failure. Bumetanide is a potent diuretic used to address fluid overload and reduce the heart's workload.

2. Packed red blood cells: The client’s urine output is low (110 mL over 6 hours), which, combined with signs of hypotension and tachycardia, may indicate significant blood loss or anemia. Administering packed red blood cells can help correct anemia and improve blood volume.


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Related Questions

Correct Answer is B

Explanation

A. The skin around the client's stoma is bulging: While bulging skin can be concerning, it is often a normal postoperative finding as the stoma settles into its new position. However, further evaluation may be needed if other symptoms are present.
B. The client has had no fecal output from the stoma: This is correct as the absence of fecal output 24 hours postoperatively could indicate a potential issue such as a blockage or anastomotic failure, which requires prompt evaluation by the provider.
C. The stoma protrudes 2 cm (0.8 in) above client's abdominal wall: This is generally considered normal. The stoma should protrude slightly to ensure it is not retracted and is functioning properly.
D. The client's stoma is moist and beefy red: This is a normal finding. A healthy stoma should be moist and beefy red, indicating good blood flow and viability.

Correct Answer is D

Explanation

A. Limit physical activity until bladder continence is achieved: Limiting physical activity is not recommended and can impact overall health. Encouraging regular activity may help improve bladder function and overall well-being.
B. Encourage the client to contract the abdominal muscles when they experience the urge to void: Contracting the abdominal muscles is not typically recommended for managing incontinence. The focus should be on bladder training and strengthening the pelvic floor muscles.
C. Instruct the client to void as soon as they feel the urge: This approach may not support bladder training, which aims to increase the time between voids to improve bladder control.
D. Instruct the client to void at scheduled times throughout the day: This is correct as scheduled voiding helps retrain the bladder, gradually increasing the intervals between voids and improving continence.

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