A client is admitted to the hospital with a history of ...

[RRMR]

A client is admitted to the hospital with a history of squamous-cell lung cancer. Upon admission, the client exhibits signs of arm and periorbital edema.
 
  Within the hour, the client exhibits dyspnea, cyanosis, tachypnea, and an altered level of consciousness. Which action should the nurse take first? 1. Call the physician
   2. Administer oxygen
   3. Monitor vital signs
   4. Initiate seizure precautions

Question 2

When a nurse works with patients who have psychophysiological insomnia, it is recommended that they get out of bed if they are not asleep within how long after going to bed?
 
  a. 10 minutes c. 30 minutes
  b. 20 minutes d. 40 minutes

[Dinolord]

Answer to Question 1

2. Administer oxygen

Rationale:
The superior vena cava can be compressed by mediastinal tumors or adjacent thoracic tumors. The most common cause is small-cell or squamous-cell lung cancers. Signs and symptoms can develop slowly and include facial, periorbital, and arm edema as early signs. As the problem progresses, respiratory distress, dyspnea, cyanosis, tachypnea, and altered consciousness and neurologic deficits can occur. Emergency measures should be given in the following order: Provide respiratory support with oxygen, and prepare for a tracheostomy; monitor vital signs; administer corticosteroids to reduce edema; if the disorder is due to a clot, administer antifibrinolytic or anticoagulant drugs; provide a safe environment, including seizure precautions.

Answer to Question 2

B
To treat psychophysiological insomnia, it is recommended that the patient get out of bed after 20 minutes if not able to fall asleep.

[RRMR]

Excellent

[bblaney]

TYSM