Spinal anesthesia

A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical unit and, after one and a half hours, now reports severe incisional pain. The patient’s blood pressure is 170/90 mm Hg, pulse is 108 beats/min, temperature is 99oF (37.2oC), and respirations are 30 breaths/min. The patient’s skin is pale, … Read more

Heart disease

A 78-year-old patient is scheduled for transition to home after treatment for heart disease. The patient’s spouse, who has chronic obstructive pulmonary disease, plans to care for the patient at home. The spouse says that their grown children, who live nearby, will help. The best approach to discharge planning is to:

Type 1 Diabetes

A patient is admitted with the following signs and symptoms: edema around the eyes upon awakening, progressing to general swelling of the legs and body; weight gain; fatigue; headache; nausea; vomiting; frequent hiccoughs; and itching. A urine specimen is obtained, and the urine is frothy. The patient has a history of insulin-dependent diabetes (type 1 … Read more

Head injury

During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical nurse notes the development of slurred speech and disorientation to time and place. The nurse’s initial action is to:

Methicillin-resistant

An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus aureus. The patient was alert and oriented on admission, but is now having visual hallucinations and can follow only simple directions. The medical-surgical nurse recognizes that the changes in the patient’s mental status are related to:

Bronchoscopic procedure

To prepare a patient on the unit for a bronchoscopic procedure, a medical-surgical nurse administers the IV sedative. The medical-surgical nurse then instructs the licensed practical nurse to: