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A nurse is monitoring a client who is postoperative following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor?

A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?

A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication?

1. A nurse is caring for a client receiving hemodialysis.

Nurses' Notes

Day 1:

1000:

Client alert and oriented x3. Lung fields clear, heart rhythm regular bowel sounds normoactive x4; ate 75% of morning meal. Denies pain. Left forearm arteriovenous (AV) fistula, skin warm, brachial and radial pulses 2+

1600:

Client returned from dialysis, lethargic, not hungry, tried to eat a few crackers but vomited them up. Capillary blood glucose 134 mg/dL. AV fistula site skin warm, bruit and thrill noted, brachial and radial pulses palpable.

Day 2:

0700:

Client reports not sleeping well last night; capillary blood glucose 75 mg/dL; crackles in left lower lobe: unproductive cough: AV fistula site ecchymotic, warm, bruit and thrill noted. Oriented to person, place, and time.

Vital Signs

Day 1:

1000:

Temperature 36.3°C (97.3°F)

Heart rate 70/min

Respiratory rate 16/min

Blood pressure 144/72 mm Hg

Oxygen saturation 94% on room air

Weight 90 kg (198 lb)

1600:

Temperature 37.1 °C (98.7°F)

Heart rate 62/min

Respiratory rate 16/min

Blood pressure 112/54 mm Hg

Oxygen saturation 95% on room air

Day 2:

0700:

Temperature 36.7°C (98.1°F)

Heart rate 62/min

Respiratory rate 12/min

Blood pressure 118/52 mmHg

Oxygen saturation 95% on room air

Weight 86.4 kg (190)

Medical History

Client has a history of type 2 diabetes mellitus, and hemodialysis with Arteriovenous fistula.

A nurse is caring for a client who has received hemodialysis. Which of the following assessment findings require follow-up?

A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?

A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)

A nurse is caring for a client who has a new arteriovenous (AV) graft in his left forearm. Which of the following techniques should the nurse use to assess the patency of this graft?

A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take?

A nurse is giving a presentation at a community center about chronic bronchitis. Which of the following information should the nurse include as effective for preventing this disorder?

A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing fluid overload?

A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). The client tells the nurse, "I can feel the congestion in my lungs, and I certainly cough a lot, but I can't seem to bring anything up." Which of the following actions should the nurse take to help this client with tenacious bronchial secretions?