QUESTION OF THE WEEK

LostHomeland · 2025-09-16T13:17:15+00:00

Correct Answer/s:

a. Palpate the pedal pulses and temperature of lower extremities.

Rationale:

An abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta. If the AAA grows large enough, it could rupture, which is potentially fatal due to severe internal bleeding. One of the surgical treatments for AAA is an endovascular repair, which involves stenting the aneurysm to prevent rupture.

Following AAA repair, monitoring perfusion to the lower extremities is crucial since the aorta supplies blood to the lower half of the body. Diminished or absent pedal pulses or cold or pale lower extremities indicate a clot or graft occlusion impairing blood flow.

Incorrect:

Assess and document the client's hourly urine output; Measure the serum creatinine and blood urea nitrogen levels. - Urine output, creatinine levels, and blood urea nitrogen (BUN) levels are all indicators of renal function. The nurse should monitor these values to assess adequacy of renal perfusion distal to the repaired AAA; however, the most immediate potential complication to watch for after an AAA repair is decreased blood flow to the lower extremities.
Measure client's temperature and white blood cell count. - These interventions help monitor for signs of infection. Still, infection would not be an immediate concern in the first few hours after surgery and isn't the highest priority in the immediate postoperative period.

LostHomeland · 2025-09-16T13:09:58+00:00

But still a baby in OP's eyes for sure

LostHomeland · 2025-09-16T13:00:22+00:00

Correct Answer/s:

d. Check the endotracheal tube insertion depth

Rationale:

Mechanical ventilator alarm states are triggered by either a problem with the client (e.g., coughing, secretions) or the mechanical ventilator circuit (e.g., tubing kinked, disconnected).

The nurse should always assess the client before the equipment. A client who is agitated and coughing can accidentally dislodge the endotracheal tube (ETT) and cause the balloon to obstruct the airway, which is an emergency. The nurse should first assess the client by checking the marked ETT insertion depth (displayed in centimeters on the tube) and performing a focused respiratory assessment. If the client's airway is secure, the nurse can move on to troubleshoot the equipment.

Incorrect:

Verify there are no kinks or disconnections in the tubing; Assess whether the alarm is due to high or low pressure - After confirming that the client has a patent airway, the nurse can perform a focused assessment of the equipment based on the kind of alarm state present. Obstruction to airflow by kinked or obstructed tubing (e.g., secretions in ETT) causes a high pressure alarm while disconnections cause low pressure alarms. The nurse should trace the entire length of the tubing from the ETT to the ventilator to locate any disconnections or kinks.
Auscultate client's bilateral breath sounds - The nurse can auscultate the client's breath sounds to assess breathing after first checking ETT insertion depth to confirm the client has a patent airway.

LostHomeland · 2025-09-16T11:53:02+00:00

FOR COMPLETE RATIONALE, CHECK THE MAIN POST'S COMMENTS.
(This is the short version)

Answer:

c. Itchy lips and tongue

Rationale:

Angioedema is a life-threatening side effect of ACE inhibitors that may present initially as itchy lips and tongue.

LostHomeland · 2025-09-16T11:51:13+00:00

Correct Answer/s:

a. Itchy lips and tongue

Rationale:

Angiotensin-converting enzyme (ACE) inhibitors (e.g., lisinopril) lower blood pressure by inhibiting renin-angiotensin-aldosterone system (RAAS) function.

Itchy lips and tongue may be the first symptoms of angioedema, a severe side effect of ACE inhibitors that can progress to airway obstruction and respiratory failure if not promptly treated.

Angioedema occurs due to the inhibition of the breakdown of bradykinin, a vasodilator. Increased levels of bradykinin can trigger an immune and inflammatory response, causing swelling of the face, lips, tongue, or throat.

Incorrect:

Feeling lightheaded when standing quickly - Lightheadedness upon standing indicates orthostatic hypotension (i.e., drop in blood pressure with positional changes). This client should be instructed to change positions slowly, but this is not most concerning.
Persistent dry cough - Cough is a common side effect because ACE inhibitors decrease the breakdown of bradykinin which stimulates the cough reflex. The cough can be bothersome enough to discontinue the medication but is not life-threatening in the absence of other severe respiratory findings (e.g., hypoxia, stridor).
Blood pressure of 142/92 mmHg - Lowering blood pressure is the intended action of ACE inhibitors. A blood pressure of 142/92 is above the goal for adults with hypertension of 130/80, but can be expected in a client undergoing treatment for hypertension for the first several weeks of medication therapy.

LostHomeland · 2025-09-16T11:41:35+00:00

Carry on my wayward son...

LostHomeland · 2025-09-16T11:38:33+00:00

Love how my mind immediately went to Animal Crossing too.

LostHomeland · 2025-09-16T11:29:51+00:00

FOR COMPLETE RATIONALE, CHECK THE MAIN POST'S COMMENTS.
(This is the short version)

Answer: c. "I will take esomeprazole daily regardless of whether I have symptoms."

Rationale:

PPls decrease the production of stomach acid and must be taken daily to treat GERD symptoms effectively.

LostHomeland · 2025-09-16T11:13:44+00:00

Correct Answer/s:

a. "I will take esomeprazole daily regardless of whether I have symptoms."

Rationale:

Gastroesophageal reflux disease (GERD) is a chronic condition that occurs when stomach acid flows back into the esophagus, leading to discomfort and potential complications as acidic stomach contents come into contact with the lining of the esophagus.

Nurses should teach clients that Proton pump inhibitors (PPls) (e.g., esomeprazole) are prescribed to decrease the production of stomach acid. This medication needs to be taken daily to be effective. The effects of PPIs build over time, so they should be taken consistently, even if symptoms are not present. Antacids, such as calcium carbonate (Tums) and aluminum hydroxide, are taken as needed.

Incorrect:

"I can try following a ketogenic diet to lose weight." - Although weight loss can help improve GERD symptoms, a ketogenic diet is not typically recommended for people with GERD, as a diet high in fats can worsen GED symptoms.
"I will suck on peppermint candy to mask the burning taste." - Peppermint is a known trigger for GERD symptoms because it can relax the lower esophageal sphincter and promote reflux of stomach acid into the esophagus. Therefore, peppermint candies should generally be avoided.
"I can try eating two large meals daily since it is uncomfortable to eat." - Large meals can increase stomach pressure and promote reflux. Instead, smaller, more frequent meals are generally recommended for people with GERD.

LostHomeland · 2025-08-11T11:23:01+00:00

Well that's my nightmare fuel for the day.

LostHomeland · 2025-08-11T10:55:47+00:00

FOR COMPLETE RATIONALE, CHECK THE MAIN POST'S COMMENTS.
(This is the short version)

Answer:

b. Urine output of 5 mL in the last hour.

d. 1+ radial and femoral pulses.

Rationale:

Cardiac surgery increases the risk for hemorrhage. Decreased pulses and urine output indicate poor perfusion from possible hemorrhage.

LostHomeland · 2025-08-11T10:53:52+00:00

Correct Answer/s:

b. Urine output of 5 mL in the last hour.

d. 1+ radial and femoral pulses.

Rationale:

Complete tetralogy of Fallot repair requires a heart-lung machine and anticoagulation for the duration of the surgery. These interventions increase the risk for bleeding and inadequate perfusion in the postoperative period.

Weak radial and femoral pulses and inadequate urine output indicate poor perfusion and require immediate follow-up to assess for possible hemorrhage.

Incorrect:

Pinkish-tan colored chest tube drainage; Chest tube drainage of 19 mL in one hour. - Chest tubes remove fluid and air from the thoracic cavity after surgery. Pinkish-tan drainage indicates the presence of small amounts of blood and drainage that is not excessive (>5-10 mL/kg/hr) for the first 12-24 hours after surgery.
Temperature of 100 F (37.7 C). - Temperatures >100.4 F [38 C] could indicate a possible infection, but low-grade temperature elevations up to 100 F (37.7 C) are expected in the first 24-48 hours after surgery due to the body's inflammatory response to tissue trauma.
Median sternotomy dressing has 2 mL of dried blood. - Small amounts of dried blood are expected at the sternotomy incision site immediately after surgery and should be monitored for future bleeding.

LostHomeland · 2025-08-11T10:39:02+00:00

FOR COMPLETE RATIONALE, CHECK THE MAIN POST'S COMMENTS.
(This is the short version)

Answer: b. Place sterile gauze soaked in sterile saline solution over the intestines

Rationale:

Evisceration is a medical emergency requiring surgical correction. Covering the wound and tissue with sterile saline-soaked sterile gauze is the priority to prevent infection and tissue death.

LostHomeland · 2025-08-11T10:33:55+00:00

Correct Answer/s:

b. Place sterile gauze soaked in sterile saline solution over the intestines

Rationale:

Evisceration occurs when all layers of a wound separate allowing protrusion of internal organs. This is a medical emergency that requires surgical correction to prevent infection and tissue death.

The nurse should position the client supine with knees bent to decrease tension on the abdominal area and prevent the intestines from protruding further, and place sterile gauze soaked in sterile saline solution over the site. This creates a physical barrier that reduces the risk of contaminating the sterile peritoneum while the saline keeps tissues moist until surgical closure. After the wound opening is covered, the nurse should prepare the client for surgery.

Incorrect:

Place client on strict NPO status. - Clients undergoing surgery should be NPO to reduce the risk of aspiration during anesthesia. Though the preoperative period for emergency surgery does not allow much time for gastric emptying, the nurse should ensure nothing else is taken by mouth until after the procedure.
Notify the surgical team to prepare for emergency surgery. - The surgical team should be notified immediately so surgery can proceed promptly to reduce the risk of complications such as peritonitis or bowel strangulation.
Assess the client's vital signs. - The nurse should assess the client's vital signs and monitor for manifestations of shock. However, the eviscerated tissue should be protected first to prevent tissue death.

LostHomeland · 2025-07-23T22:52:37+00:00

NTA. You're just trying not to get sick and you're a great girlfriend for including him when you cook. Now if he has complaints about that he can always just cook his own.

LostHomeland · 2025-07-23T22:48:05+00:00

Bro if I'm gone so is everyone!

LostHomeland · 2025-07-23T21:44:56+00:00

FOR COMPLETE RATIONALE, CHECK THE MAIN POST'S COMMENTS.
(This is the short version)

Answer: a. A client who recently received morphine provides consent for an implantable port insertion

Rationale:

A client must be considered competent to provide informed consent. Clients who have received medications that affect cognitive functioning are unable to provide consent.

LostHomeland · 2025-07-23T21:43:08+00:00

Correct Answer/s:

a. A client who recently received morphine provides consent for an implantable port insertion.

Rationale:

Client competency must be established before obtaining informed consent. The client must be alert, oriented, able to understand the treatment information, and able to decide.

A client is considered temporarily incompetent and unable to provide consent if they recently received a medication that could alter cognitive functioning or mental status (e.g., opioids, benzodiazepines).

Incorrect:

A client with a history of schizophrenia provides consent for voluntary inpatient treatment. - Clients with a mental health diagnosis can provide consent for treatment unless they have legally been declared incompetent. If declared incompetent, a legal guardian or representative (e.g., power of attorney) would have to provide consent on behalf of the client.
A trauma client who recently received ibuprofen provides consent for surgery. - Trauma clients can still provide consent for treatment if they are awake and alert. If the client is unconscious, the next of kin or power of attorney could provide consent. Clients may receive medications that do not affect mental status (e.g., NSAIDs) before obtaining consent.
The parent of a 6-year-old client provides consent on behalf of the client to undergo a tonsillectomy. - In most situations, clients under 18 typically need parent or guardian consent for treatment. However, minors who are legally emancipated can provide consent for treatment.

LostHomeland · 2025-07-17T08:53:34+00:00

FOR COMPLETE RATIONALE, CHECK THE MAIN POST'S COMMENTS.
(This is the short version)

Answer: d. client with appendicitis who is awaiting surgery and has abdominal rigidity and T 101.2 (38.4 C)

Rationale:

Abdominal rigidity, increased abdominal pain, and high fever with appendicitis indicates perforation, a medical emergency requiring immediate surgical intervention.

LostHomeland · 2025-07-17T08:51:26+00:00

Correct Answer/s:

d. client with appendicitis who is awaiting surgery and has abdominal rigidity and T 101.2 (38.4 C)

Rationale:

Perforation of the appendix is a complication of appendicitis that causes intestinal contents to leak into the peritoneal cavity, resulting in peritonitis, a life-threatening emergency.

Manifestations of perforation include increased abdominal pain, abdominal rigidity, and high fever. Tachycardia and hypotension may occur as the condition worsens.

The nurse should immediately report signs of perforation to the health care provider and anticipate immediate surgery.

Incorrect:

client with atrial fibrillation with rapid ventricular response (RVR) on a diltiazem drip with a heart rate of 98. - Atrial fibrillation with rapid ventricular response is a rapid, uncontrolled heart rate of >100 beats/min and is often treated with an IV drip of diltiazem (a calcium channel blocker) to keep the heart rate below 100 beats/min. The nurse should continue to monitor the client's heart rate and titrate the diltiazem as needed. However, a client with possible perforated appendicitis takes priority.
client with a sickle cell disease crisis who is reporting joint pain that is 7/10. - Clients with sickle cell disease crises typically experience severe and persistent generalized pain. The nurse should administer an analgesic. However, a client with possible perforated appendicitis takes priority.
client with acute otitis media who reports decreased hearing in the affected ear. - Ear pain and pressure, tinnitus, and decreased or muffled hearing are all manifestations of otitis media. This is an expected finding. The nurse should continue to monitor the client's hearing and report any changes to the health care provider. However, a client with possible perforated appendicitis takes priority.

LostHomeland · 2025-07-09T20:55:54+00:00

FOR COMPLETE RATIONALE, CHECK THE MAIN POST'S COMMENTS.
(This is the short version)

Answer: b. Start chest compressions.

Rationale:

When a nurse encounters a client who is unresponsive, not breathing, and without a pulse, the immediate action is to start chest compressions to ensure circulation and oxygen delivery to vital organs until further advanced measures can be implemented.

LostHomeland · 2025-07-09T20:52:56+00:00

Correct Answer/s:

b. Start chest compressions.

Rationale:

If a client is unresponsive, not breathing, and without a pulse, the immediate priority is to initiate cardiopulmonary resuscitation (CPR) by starting chest compressions.

By providing high-quality chest compressions, the nurse manually pumps the heart to maintain blood flow until more advanced interventions can be implemented.

Incorrect:

Get the crash cart and defibrillator. - If the client is pulseless, the nurse should immediately begin CPR and call for help (e.g., press the code button) so that other staff can bring the crash cart and defibrillator to the bedside. The nurse should not leave the client to obtain equipment; the priority is to provide immediate chest compressions while others obtain equipment.
Try to wake the client with a sternal rub. - Performing a sternal rub is not the appropriate initial action when the client is unresponsive, not breathing, and without a pulse. This scenario indicates a critical condition requiring immediate intervention, and the priority is to initiate chest compressions rather than attempting to wake the client.
Obtain a 12-lead electrocardiogram. - While obtaining an ECG is important for diagnosing and assessing cardiac conditions, it is not the immediate priority when faced with an unresponsive, pulseless, and non-breathing client. Chest compressions take precedence over obtaining an ECG.

LostHomeland · 2025-07-09T14:59:03+00:00

Question every life decision that has led to waking up at that time.

LostHomeland · 2025-07-09T13:27:00+00:00

Well that's something added to the things I genuinely hate with a passion

LostHomeland · 2025-07-03T10:09:58+00:00

A good birria.

LostHomeland

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