A patient who is hospitalized with a pelvic fracture after a ...

[jwb375]

A patient who is hospitalized with a pelvic fracture after a motor vehicle accident just received news that the driver of the car died from multiple injuries.
 
  What actions should the nurse take based on knowledge of the physiologic stress reactions that may occur in this patient (select all that apply)?
  a. Assess for bradycardia.
  b. Ask about epigastric pain.
  c. Observe for decreased appetite.
  d. Check for elevated blood glucose levels.
  e. Monitor for a decrease in respiratory rate.

Question 2

A patient who is taking antiretroviral medication to control human immunodeficiency virus (HIV) infection tells the nurse about feeling mild depression and anxiety.
 
  Which additional information about the patient is most important to communicate to the health care provider?
  a. The patient's blood pressure is 152/88 mm Hg.
  b. The patient uses over-the-counter St. John's wort.
  c. The patient recently experienced the death of a close friend.
  d. The patient expresses anxiety about whether the drugs are effective.

[leannegxo]

Answer to Question 1

ANS: B, C, D
The physiologic changes associated with the acute stress response can cause changes in appetite, increased gastric acid secretion, and increase blood glucose levels. In addition, stress causes an increase in respiratory and heart rates.

Answer to Question 2

ANS: B
St. John's wort interferes with metabolism of medications that use the cytochrome P450 enzyme system, including many HIV medications. The health care provider will need to check for toxicity caused by the drug interactions. Teaching is needed about drug interactions. The other information will also be reported but does not have immediate serious implications for the patient's health.