For which of the following client situations would a consultation ...

[stevenposner]

For which of the following client situations would a consultation with a rapid response team (RRT) be most appropriate?
 
  1. 45-year-old, 2 years after kidney transplant, second hospital day for treatment of pneumonia, no urine output for 6 hours, temperature 101.4 F, heart rate 98 beats/min, respirations 20 breaths/min, blood pressure 168/94 mm Hg
  2. 72-year-old, 24 hours after removal of a chest tube that was used to drain pleural fluid (effusion), temperature 97.8 F, heart rate 92 beats/min, respirations 28 breaths/min, blood pressure 136/86 mm Hg, anxious about going home
  3. 56-year-old, fourth hospital day after coronary artery bypass procedure, sore chest, pain with walking, temperature 97 F, heart rate 84 beats/min, respirations 22 breaths/min, blood pressure 122/78 mm Hg, bored with hospitalization
  4. 86-year-old, 48 hours after operative repair of fractured hip (nail inserted), alert, oriented, using patient-controlled analgesia (PCA) pump, temperature 96.8 F, heart rate 60 beats/min, respirations 16 breaths/min, blood pressure 120/82 mm Hg, talking with daughter

Question 2

The client complains of chronic pruritus. Which of the following diagnoses would the nurse expect to support this client's complaint?
 
  1. Anemia
  2. Renal failure
  3. Hypothyroidism
  4. Diabetes mellitus

[kswal303]

Answer to Question 1

1

Rationale: The role of an RRT is to provide internal consultative services to staff nurses to detect client problems early. 45-year-old, 2 years after kidney transplant, second hospital day for treatment of pneumonia, no urine output for 6 hours, temperature 101.4 F, heart rate 98 beats/min, respirations 20 breaths/min, blood pressure 168/94 mm Hg describes a client who may be rejecting the transplanted kidney. The constellation of symptoms described indicates possible rejection. Internal consultation could validate that assessment. 72-year-old, 24 hours after removal of a chest tube that was used to drain pleural fluid (effusion), temperature 97.8 F, heart rate 92 beats/min, respirations 28 breaths/min, blood pressure 136/86 mm Hg, anxious about going home, 56-year-old, fourth hospital day after coronary artery bypass procedure, sore chest, pain with walking, temperature 97 F, heart rate 84 beats/min, respirations 22 breaths/min, blood pressure 122/78 mm Hg, bored with hospitalization, and 86-year-old, 48 hours after operative repair of fractured hip (nail inserted), alert, oriented, using patient-controlled analgesia (PCA) pump, temperature 96.8 F, heart rate 60 beats/min, respirations 16 breaths/min, blood pressure 120/82 mm Hg, talking with daughter indicate expected characteristics of the clients described and provide no indication of need for RRT consultation.

Answer to Question 2

2

Rationale: Clients with renal failure often have pruritus, or itchy skin. This is because of impaired clearance of waste products by the kidneys. The client who is markedly anemic is likely to have pale skin. Hypothyroidism may lead to complaints of dry skin. Clients with diabetes mellitus are at risk for skin infections and skin breakdown.

[stevenposner]

TYSM

[adammoses97]

Excellent