An infant is admitted to the hospital because of having frequent diarrheal stools with acute rotaviral infection. The nurse notes 40 to 60 bowel sounds per minute. The child has poor skin turgor, and the mucous membranes are dry. The nurse would make a nursing diagnosis of Deficient fluid volume related to
A. insufficient antidiuretic hormone.
B. inability to metabolize nutrients.
C. decreased gastric emptying.
D. increased gastrointestinal motility.
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Mrs. Wilson, a primigravida, was admitted to the hospital at 12 weeks’ gestation. She is complaining of abdominal cramping, exhibits bright red vaginal spotting without cervical dilation. The nurse determines that the client is most likely experiencing which of the following types of abortion
A. Complete.
B. Threatened.
C. Inevitable.
D. Misse
A client is having autonomic dysreflexi
A. a. What should the nurse do firstA. Place the client in Fowler’s position.B. Send a urine sample for culture.C. Administer nitroprusside sodium (Nipride) intravenously.D. Call the physician.
A client is at risk for developing a pressure ulcer. The first warning of an impending pressure ulcer is when pressure applied to skin it turns
A. whitish.
B. yellowish.
C. bluish.
D. reddis
A client with a retinal detachment does not understand what happened to his eye and asks the nurse’s explanation. Which of the following would be the nurse’s best response to describe the pathology of retinal detachment
A. "The optic nerve is damaged when it is exposed to vitreous humor. "
B. "A tear in the retina permits the escape of vitreous humor from the eye. "
C. "The two layers of the retina separate, allowing fluid to enter between them. "
D. "Retinal injury produces inflammation and edema that increase intraoeular pressure. "