RN Adult Medical Surgical Online Practice 2023 A NGN

NGN 1000: Client is alert and oriented and reports not feeling well for a few days. Client is on continuous ambulatory peritoneal dialysis (CAPD) and reports dialysate appeared cloudy this morning. Reports abdominal pain as 4 on a scale of 0 to 10. Bowel sounds active in all quadrants. Peritoneal dialysis access site red, warm to touch, with a small amount of purulent drainage noted on dressing.1300: Client is lying in bed with the knees flexed, guarding the abdomen. Abdomen is slightly distende - The client is experiencing manifestations of peritonitis due to x-ray results . NGN Client admitted to medical-surgical unit from PACU. Client reports incisional pain as 2 on a scale of 0 to 10. Client appears restless and frequently asks for water. Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40 mL for the past 2 hr. Moderate amount of bright red drainage noted on surgical incision dressing. - Insert a large-gauge IV. Initiate a fluid challenge. Hypovolemia Urine output Blood pressure A nurse is caring for a client who has a potassium level of 3 mEq/L. Which of the following assessment findings should the nurse expect? - Hypoactive Bowel Sounds NGN 0900: Client presents with abdominal pain in the upper left quadrant for the past 2 days. States pain became worse this morning and is radiating to the back. Rates pain as 8 on a scale of 0 to 10. Hypoactive bowel sounds; reports nausea, no vomiting; client is passing flatus. Febrile, oriented to person, place, and time. Tachypnea with diminished breath sounds. Sinus tachycardia. Client voids 300 mL of clear, amber urine. 0930: Client vomited 100 mL brown liquid. - The client is experiencing manifestations of pancreatitis as evidenced by the amylase and lipase . 0530: Client is awake and alert. Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated for bruit. Lung sounds clear upon auscultation; client denies shortness of breath. No peripheral edema noted; capillary refill is less than 3 seconds; +2 bilateral pedal and radial pulses. AVF access prepared and cannulated twice with no difficulty. Lines are taped and secured; treatment is initiated.0600: Client is reading a book. Access is visible, and lines are secure. Client rep - Perform a 12-lead ECG is not indicated. Place the client in Trendelenburg position is indicated. Administer a 0.9% sodium chloride 200 mL IV bolus is indicated. Apply oxygen at 2 L/min via nasal cannula is indicated Notify the provider immediately is indicated Obtain the client's blood glucose level is not indicated. 1800: Emergency medical team removed client's shirt at the scene and initiated 18-gauge IV therapy in the right antecubital space. Client has full-thickness burns over the upper half of the chest and both forearms; partial-thickness burns are present on the client's face and neck. Sinus tachycardia, pulses to brachial extremities palpable. 1+ edema to upper extremities. Respirations even, labored with scattered rhonchi. Soot noted to the client's mouth and nose. Oxygen 40% via face tent applied. - During the emergent phase of burn care, the client is at risk for developing hypovolemia and respiratory failure .