Exam (elaborations) NUR 2311

Nurse plans to administer a dose of metoprolol at 0900 to a client with HTN. At 0800 nurse notes telemetry pattern shows second degree heart block with Ventricular rate of 50. Action Nurse is reviewing client ECG and determines PR interval prolonged. Indicates When assessing a restless, intubated client on mechanical ventilation, nurse auscultates breath sounds on right side only. Action Nurse called to a train derailment likely caused by terrorist bomb. Triage in order Client with pneumonia admitted with severe SOB, ABGs pH 7.30, PaO2 60, PaCO2 62, HCO3 35. Which needs immediate communication to HCP Assess a 78 year old with L sided HF. Symptoms Caring for a burn patient with serum potassium of 4. Question which medication Patient admitted with deep 2nd degree burns of thighs, chest and arms covering 40% BSA. Fluid shift after burn so nurse expects Patient bedridden for 2 wks with following lab values: pH 7.37, PO2 90, PCO2 40, HCO3 25, hypoalbuminemia and hypocalcemia. Priority action Which age group should nurse assess first There has been a major disaster. Triage nurse should give which patient priority Move which patient to medical surgical unit One open bed in ICU but reserved for patient coming from PACU with respiratory problems, what to do Carotid picture ..............................................Continued.......................................