The nurse is assessing a patient who was recently admitted to the ...

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The nurse is assessing a patient who was recently admitted to the emergency department with dysrhythmias and shortness of breath. Which baseline nursing assessment(s) should be the priority(ies)? (Select all that apply.)
 
  a. ECG monitoring
  b. Medication history
  c. Oxygen saturation
  d. Presence of chest pain, dyspnea, and fatigue
  e. Mental status
  f. Sleep pattern

Question 2

A patient is admitted to the telemetry unit with a diagnosis of cardiovascular disease.
 
  When performing the initial assessment, the nurse records blood pressure in the left arm of 142/84, blood pressure in the right arm of 138/80, temperature of 98.8 F, and radial pulse of 80 that is weak and irregular. The nurse should notify the physician regarding
  a. both blood pressure and pulse.
  b. blood pressure only.
  c. pulse only.
  d. both blood pressure and temperature.

[kardosa007]

Answer to Question 1

ANS: A, B, C, D, E
Baseline nursing assessment of patients with dysrhythmias includes ECG monitoring, medication and medical histories, oxygen saturation, observation for the six cardinal signs of cardiovascular disease, and neurologic assessment. Sleep pattern history is not a priority for this patient.

Answer to Question 2

ANS: C
Irregular pulse rate and rhythm should be reported. A systolic pressure variance of 5 to 10 mm Hg is normal; readings reflecting a variance of more than 10 mm Hg should be reported for further evaluation. Temperature is within normal limits.

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TY

[kardosa007]

You're welcome