Answer to Question 1
A
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The signs and symptoms of hypernatremia are thirst, dry mucous membranes, flushed dry skin, and hypotension (if accompanied by FVD) and neurologic findings. Hyperkalemia manifests as vague muscle weakness initially, with skeletal muscle weakness possibly progressing to paralysis, paresthesias, and dysrhythmias. Hypercalcemia presents as dysrhythmia, hypertension, muscle weakness, depressed reflexes, and altered states of consciousness progressing to coma. Hypermagnesemia causes weakness, diminished deep-tendon reflexes, muscle weakness, and hypotension with peripheral vasodilation.
Answer to Question 2
C
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The nurse should assess the mother carefully for hemorrhage following a placenta previa delivery. If attempts to control severe bleeding are unsuccessful, an emergency hysterectomy will be required. When caring for a client with abruptio placentae, the nurse observes her for extreme pain, which may indicate bleeding and pooling behind the placenta. The nurse measures the abdominal girth with a measuring tape for a client with abruptio placentae to monitor any rise in uterine fundus.
Assessing skin turgor.
Skin lesions.
Sample client goals from the Wellness Massage Pyramid.
Using small, circular strokes, exfoliate the client’s neck and back.
Approaching the client for the ophthalmoscopic exam
A patient is talking to the nurse about her husband’s abuse and attempt to strangle her. She ...