MED SURG II: ATI NGN QUESTIONS FOR HEMATOLOGY 100% PASS
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Course
MED SURG II: ATI NGN
Institution
MED SURG II: ATI NGN
MED SURG II: ATI NGN QUESTIONS FOR HEMATOLOGY 100% PASS
1. 1a)
A nurse is caring for a client in the
emergency department (ED).
Nurses' Notes
1500:
Client presents to the ED and
reports dyspnea, chest pain,
and tachycardia. Client returned
home from a vacation out of the
country 24 hr ago...
MED SURG II: ATI NGN QUESTIONS FOR HEMATOLOGY 100% PASS
1. 1a) 1b)
A nurse is caring for a client in the The nurse should first fol-
emergency department (ED). lowed by
Nurses' Notes First:
1500: place the client in high-Fowler's position
Client presents to the ED and obtain a doppler ultrasound
reports dyspnea, chest pain, administer an anticoagulant
and tachycardia. Client returned obtain ABGS
home from a vacation out of the
country 24 hr ago. Followed by:
1515: placing the client on telemetry
The client has become diaphoret- initiating bleeding precautions
ic, increasingly dyspneic, and obtaining IV access
states that their chest pain is obtaining vital signs
sharp and increasing. The client
states, "I feel like I'm going to
die." Crackles auscultated in bi-
lateral lower lobes, S3 and 54
heart sounds noted. Petechiae
noted on the client's chest. Pul-
monary embolism protocol initi-
ated.
Vital Signs
1500:
Temperature: 38.1° C (100.6° F)
Heart rate: 110/min
Respiratory rate: 24/min
BP: 138/52 mm Hg
Oxygen saturation: 92% oxygen
at 2 L/min via nasal cannula
1515:
Temperature: 38.1° C (100.6° F)
Heart rate: 135/min
Respiratory rate: 32/min
BP: 120/50 mm Hg
Oxygen saturation: 90% on 4
L/min via nasal cannula
, MED SURG II: ATI NGN QUESTIONS FOR HEMATOLOGY 100% PASS
2. 2a) Physical Examination
A nurse is caring for a client who
0800:
was recently admitted and has Alert and oriented to person and place
symptomatic bradycardia. Skin pale and dry
Pupils equal, round, and reactive to
Vital Signs light and accommodation Mucous mem-
Temperature 36.6° C (97.8° F) branes moist and pink
Apical pulse 42/min Heart sounds regular and moderate
Respiratory rate 26/min Peripheral pulses moderate
Blood pressure 104/68 mm Hg Capillary refill 3 seconds
Oxygen saturation 94% on room Lungs sounds clear to auscultation bilat-
air erally
Respirations labored at rest
Diagnostic Results Abdomen soft and nontender, active
CBC: bowel sounds × 4 quadrants
RBC count 5.2 million/mm? (4.7 No peripheral edema
to 6.1 million/mm3) Reports slight midsternal chest pain,
WBC count 7,000 mm3 (5,000 to rates pain as a 2 on a 0 to 10 pain scale
10,000 mm3) States they have been weak for the past
Hemoglobin 15.4 g/dL (14 to 18 4 months with dizziness. Denies dizzi-
g/dL) ness at this time.
Hematocrit 48% (42% - 52%)
Platelets 250,000/mm3 (150,000 1300:
to 400,000/mm3) Returns to room after insertion of perma-
Basic Metabolic Profile: nent pacemaker
BUN 18 mg/dL (10 to 20 mg/dL) Alert and oriented to person, needs cues
Creatinine 1.0 mg/dL (0.6 to 1.3 for time and place
mg/dL) Skin cool and dry
Total Calcium 9.5 mg/dL (9.0 to Heart sounds regular, heart rate 72/min
10.5 mg/dL) Lung sounds are coarse bilaterally
Carbon Dioxide 27 mEq/L (23 to Hyperresonance noted upon percussion
30 mEq/L) of chest wall
Chloride 101 mEq/L (98 to 106 Respiratory rate 24/min and slightly la-
mEq/L) bored
Glucose 80 mg/dL (74 to 106 Oxygen saturation 2 L/min per nasal can-
mg/dL) nula 98%
Potassium 5.1 mEq/L (3.5 to 5 Reports slight incisional pain left upper
mEq/L) chest area
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