A frail, older patient is in the emergency room in severe ...

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A frail, older patient is in the emergency room in severe respiratory distress. The patient has had repeated hospitalizations for the same thing. After stabilizing the patient, which action by the nurse is most appropriate?
 
  a. Determine what the patient's end-of-life wishes are.
  b. Assess the family caregiver for compliance with treatment.
  c. Administer intravenous (IV) fluids at a rapid rate.
  d. Prepare to vaccinate the patient against pneumonia.

Question 2

A nurse is caring for the older patient who had knee replacement surgery 8 days ago. What assessment by the nurse is most important?
 
  a. Determining whether the patient has sen-sation to the foot
  b. Asking the patient to rate his or her cur-rent pain.
  c. Observing the incision site for redness or drainage.
  d. Monitoring the calf circumference on the affected side

[sokh]

Answer to Question 1

A
Because of the lifesaving modalities needed to care for such a patient, the nurse and physician work together to determine what the patient's end-of-life wishes are. In the emergency depart-ment, patient stabilization comes first, but once this has been accomplished a discussion should occur with the patient and family about further treatment desires. The family caregiver may or may not be adherent, or the patient may assume all self-care. IV fluids should not be given at a rapid rate because of the risk of heart failure. The patient should receive an immunization against pneumonia per guidelines.

Answer to Question 2

D
Major complications after joint replacement surgery include thromboembolism (deep venous thrombosis DVT), joint or wound infection, blood loss, nerve injury, joint dislocation, and sur-gical pain. The risk of DVT is highest between the first and second week after surgery. An in-crease in calf circumference can indicate the presence of a DVT. The other assessments are ap-propriate but not as critical.

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Excellent

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TYSM