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, 1 of 42
Definition
Nasal flaring
MY ANSWER The nurse should report any indications of respiratory
distress such as nasal flaring, retractions, and grunting.
--Heart rate 136/minA heart rate of 136/min is within the expected
reference range of 110/min to 160/min for a newborn.
--Transient strabismusTransient strabismus or nystagmus is an
expected finding for a newborn until the age of 3 to 4 months.
--Overlapping of suturesOverlapping of sutures occurs with molding
following a vaginal delivery and is an expected finding for a
newborn.
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client with immunosuppression
and continuous iv. what actions decreased visual acuity with
should you take cataracts. what change
assessing a newborn after
birth. which of the following potassium level of 3.0 (3.5-5),
should you report to provider monitor what
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2 of 42
Definition
,Avoid venipunctures when possible.
MY ANSWER
Clients who have thrombocytopenia have a decreased platelet
count and are at risk for bleeding. To reduce the risk for bleeding,
the nurse should avoid venipunctures when possible.
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instructions to a pt
with hypertension guidelines for a pt with anemia
recommendations for a pt instructions to a pt
with leukopenia with
thrombocytopenia
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3 of 42
Definition
Ask the partner to list specific concerns.
MY ANSWER
The first action the nurse should take using the nursing process is to
assess the situation by asking the partner to list specific concerns.
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discuss the client's treatment partner says client not
plan with the partner. receiving adequate care
, review the client's medical observe the client's symptoms and
history with the partner. document them.
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4 of 42
Definition
Use 0.9% sodium chloride for irrigation of the NG tube.The nurse
should use 0.9% sodium chloride, sterile water, or tap water for
irrigation of the client's NG tube.
--Instill chilled lavage solution into the client's NG tube.The nurse
should use lavage solution that is at room temperature to reduce the
risk of injury to the client.
--Attach the client's NG tube to low intermittent suction.After
instilling the lavage solution, the nurse should manually withdraw the
solution and blood from the client's NG tube.
--Instill the lavage solution into the client's NG tube in volumes of
500 mL at a time.The nurse should instill the solution in volumes of
200 to 300 mL at a time to reduce the risk of injury to the client.
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decreased visual acuity performing gastric lavage with
with cataracts. what nasogastric tube
change
planning care for pt with potassium level of 3.0 (3.5-5),
mechanical restraints monitor what