The nurse is in the G unit is assessing a patient after receiving the change of shift SBAR report. What assessment findings will the nurse report immediately to the provider?

The patient who is having white milky liquid stools immediately after a barium enema.

The patient with irritable bowel syndrome (IBS) who has not had a bowel movement for three days.

The patient diagnosed with ulcerative colitis with a temperature of 101°F and abdominal distention.

The patient receiving Total Parenteral Nutrition (TPN) whose blood glucose level is 225 mg/dL.

Answer and Explanation

The Correct Answer is C

Choice A reason: White milky liquid stools immediately after a barium enema are not uncommon and are typically due to the passage of barium. This finding does not usually require immediate reporting unless there are other concerning symptoms.

Choice B reason: Not having a bowel movement for three days in a patient with irritable bowel syndrome (IBS) can be uncomfortable but is not typically an emergency. Management can be addressed through dietary and medication adjustments rather than immediate reporting.

Choice C reason: A temperature of 101°F and abdominal distention in a patient diagnosed with ulcerative colitis is concerning and should be reported immediately. These symptoms can indicate a serious complication such as toxic megacolon, perforation, or severe infection, which require prompt medical intervention.

Choice D reason: A blood glucose level of 225 mg/dL in a patient receiving Total Parenteral Nutrition (TPN) is elevated but not necessarily an emergency. Elevated blood glucose levels are a common side effect of TPN and can be managed through adjustments in insulin or TPN composition.

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Correct Answer is B

Explanation

Choice A reason: Acute hemolytic reactions are severe and typically present with symptoms such as fever, chills, flank pain, hemoglobinuria, and shock. The patient's mild symptoms of itching and a localized rash do not match the severe presentation of an acute hemolytic reaction.

Choice B reason: Allergic reactions to blood transfusions are common and usually present with symptoms such as itching, hives, and localized rash. The patient's vital signs and physical assessment showing mild itching and a rash on the arms are consistent with an allergic reaction.

Choice C reason: Anaphylactic reactions are severe allergic reactions that involve respiratory distress, hypotension, and shock. The patient's mild symptoms do not indicate an anaphylactic reaction.

Choice D reason: Circulatory overload presents with symptoms such as dyspnea, orthopnea, hypertension, and pulmonary edema. The patient's symptoms of itching and a rash do not align with circulatory overload.

A. Albuterol, 2 inhalations B. Beclomethasone, 2 inhalations C. Fluticasone and salmeterol, 1 inhalation D. Tiotropium, 2 inhalations

Correct Answer is A

Explanation

Choice A reason: Albuterol is a short-acting beta-agonist that helps to quickly relieve bronchospasm, reduce wheezing, and improve airflow in patients with COPD exacerbations.

Choice B reason: Beclomethasone is an inhaled corticosteroid used for long-term control of inflammation in COPD but is not the first-line treatment for acute exacerbations.

Choice C reason: Fluticasone and salmeterol is a combination inhaler used for maintenance therapy in COPD, providing both anti-inflammatory and long-acting bronchodilation effects, but not ideal for immediate symptom relief.

Choice D reason: Tiotropium is a long-acting anticholinergic bronchodilator used for maintenance treatment in COPD but is not the best choice for acute symptom management.

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The nurse is in the G unit is assessing a patient after receiving the change of shift SBAR report. What assessment findings will the nurse report immediately to the provider?

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Explanation

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