Deck 53: Integration

Question 1

A 45-year-old male client with a history of hypertension for 5 years develops symptoms of congestive heart failure (CHF)and renal failure.What are some of the possible reasons the client has developed CHF and renal failure? Describe the areas in which nursing intervention with this client could have helped prevent development of these complications.

Answer 1

The following are suggested guidelines for grading.
The client with hypertension may develop CHF and renal failure for several reasons: (1)inability to comply with prescribed treatment plan,including taking medications and following a restricted sodium diet;(2)other lifestyle factors,such as smoking,weight gain,alcohol intake,stress,and lack of exercise;and (3)pathophysiological changes resulting from increased peripheral resistance related to plaque buildup or vasoconstriction and cardiac hypertrophy.
Nurses,in conjunction with other health care team members,can help the client learn more about his disease and the goals of treatment.Nurses can instruct the client in how to take blood pressure and monitor trends in the readings obtained,including when to notify the primary care provider,and basic information about prescribed medications,including side effects.Nurses can also help the client identify lifestyle factors that can be modified to assist in blood pressure control,such as smoking cessation,a low-sodium diet,weight loss if necessary,and more exercise.Nurses can monitor how well the client is following through with these aspects when the client returns for periodic visits.

Question 2

A nurse is reviewing the health records of assigned clients.The nurse plans care knowing that which client is likely at risk for the development of third-spacing? (Select all that apply. )

A)the client with cirrhosis
B)the client with diabetes mellitus
C)the client with sepsis
D)the client with renal failure
E)the client with pneumonia

Answer 2

the client with cirrhosis
the client with diabetes mellitus
the client with sepsis
the client with renal failure

Question 3

A 60-year-old male client has just been diagnosed as having type 2 diabetes.The client is 30 pounds overweight and knows very little about his condition.What are the major points that the nurse should include in this client's teaching plan?

Answer 3

The following are suggested guidelines for grading.
A teaching plan should include such things as a basic understanding of type 2 diabetes,review of prescribed oral hypoglycemic drug and its possible side effects,dietary management,importance of exercise,use of blood-glucose-monitoring equipment,symptoms of hypoglycemia,importance of ongoing medical management,foot care,and prevention of complications.

Question 4

A nurse is caring for a client with cirrhosis.The nurse notes that the client is dyspneic,and crackles are heard on the auscultation of the lungs.The nurse suspects fluid volume excess secondary to congestive heart failure (CHF).What additional signs would the nurse expect to see if the cardiovascular system is being affected?

A)flat hand and neck veins
B)a weak and thready pulse
C)an increase in blood pressure
D)an increased urine output

Question 5

A 45-year-old female client who has a history of alcohol abuse develops severe jaundice and confusion;she also complains of nausea and indigestion.The client's blood pressure is elevated,both lower extremities are edematous,and the liver is enlarged.The client is admitted for treatment with a medical diagnosis of cirrhosis.What nursing diagnoses and interventions would be appropriate for this client?

Question 6

The nurse reviews the client's medical record listed below and would contact the physician regarding which of the following documented findings?
CLIENT'S CHART
Laboratory Test Result
Blood glucose,142 mg/dL
BUN,58 mg/dL
Serum creatinine,8 mg/dL
Client's History
Renal insufficiency,diabetes mellitus
Medication History
Folic acid (vitamin B?)orally daily
Glucophage orally twice a day
Diagnostic Test Result
Chest X-ray: normal

A)Medication history
B)Client's history
C)Diagnostic test result
D)Laboratory test results

Question 7

The nurse is providing instruction to a client with diabetes mellitus regarding peritoneal dialysis.The nurse explains to the client that it is important to maintain the dwell time for the dialysis at the prescribed time.The nurse is aware that the rationale for this is because of the risk of:

A)infection
B)hyperglycemia
C)fluid overload
D)disequilibrium syndrome

Question 8

A 68-year-old female client notices the gradual development of muscular weakness,resting tremors in the upper extremities,and some muscular rigidity.Her health care provider makes a tentative diagnosis of Parkinson's disease and refers the client to a neurological specialist who confirms the diagnosis.What information could the nurse provide to the client and her family about the nature of Parkinson's disease? What are some of the things that the client and her family should prepare to cope with as the disease progresses? Describe key aspects of a teaching plan for the client and her family.

Question 9

A client has just been diagnosed as having type 2 diabetes.The client is a 60-year-old male who is 30 pounds overweight.He is married and has two grown children.What are several things the nurse who is assigned to this client needs to do before developing a plan of care for the client?

Question 10

At a routine checkup,a 40-year-old female client who has had type 1 diabetes for 5 years has a blood pressure reading of 180/110;previous blood pressure readings have been within a range of 120/80 to 130/85.What nursing interventions would be appropriate for this client?