Which assessment finding on a patient who had a right total knee ...

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Which assessment finding on a patient who had a right total knee replacement this morning should be reported to the charge nurse immediately?
 
  a. Pain level of 8 at operative site
  b. Capillary refill of right toe of 7 seconds
  c. Right foot warm to touch
  d. Swelling of right knee

Question 2

The nurse is caring for an older adult patient. While auscultating the patient's apical pulse, the nurse notices an irregular rhythm. The nurse suspects which causative factor for the patient's dysrhythmia?
 
  a. Loss of cells in the sinoatrial (SA) nodes
  b. Increased peripheral resistance
  c. Hypertension
  d. Atherosclerosis

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Answer to Question 1

B
Capillary refills should be brisk, less than 3 seconds. Pain and swelling are expected at this early postoperative time. A warm foot is a normal finding.

Answer to Question 2

A
Loss of cells in the SA nodes via age-related changes is the most common cause of dysrhythmias in the older adult. This nurse should, however, document these findings and report the findings to the primary care provider.