4. A nurse is assessing a client following extubating from a ventilator. For which of the following findings should the nurse intervene immediately?
A. SaO2 92%
C. Sore throat
5. A nurse is caring for a client who has an arteriovenous graft. Which of the following findings indicates adequate circulation of the graft?
A. Normotensive blood pressure
B. Absence of a bruit
C. Dilated appearance of the graft
D. Palpable thrill
49. A nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP). The client
reports sharp lower abdominal pain. Which of the following actions should the nurse take first?
A. Check the client's urine output.
B. Administer PRN pain medication
C. Increase the client's fluid intake.
D. Reposition the client in bed
50. A nurse is caring for a client who is the caregiver for a relative who has a chronic disease. Which of the following statements indicates the client is adapting to the role change?
A. "I need to get my blood pressure medicine refilled."
B. had to reschedule my doctor's appointment last week."
C. "I've lost 15 pounds in the past 2 months."
D. "I have lunch with my friends once a week."
1) * PLACE THE CLIENTS RESIDUAL LIMB IN A DEPENDENT POSITION WHEN POSSIBLE- THIS HELPS TO PREVENTION OF OEDEMA AFTER AMPUTATION. * PROVIDE THE CLIENTS WITH FIRM MATTRESS- FIRM MATTRESS IS ESSENTIAL TO PREVENT MUSCLE CONTRACTURES. * WRAP THE CLIENTS RESIDUAL LIMB WITH ELASTIC BANDAGE IN A DISTAL TO PROXIMAL DIRECTIONS. - TO PREVENT INFECTION AND OEDEMA AFTER AMPUTATION. THE OTHER OPTION- KEEP THE CLIENT IN A SUPINE POSITION FOR THE 48 HOURS- THE POSITION GIVEN AFTER BELOW KNEE AMPUTATION IS PRONE POSITION IS HELPS TO STRETCHES THE MUSCLE AT FRONT OF THE HIPS.
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