A nurse is caring for an elderly client on the medical surgical floor. History and Physical 1 year ago: At office visit client reports taking aspirin a couple times each day for pain for the last couple weeks as discomfort has increased since last doctor visit 8 months ago. Client states they were a runner and completed multiple 5K and marathon races when in their 30s and 40s. 6 months ago: At annual wellness visit, no significant findings noted in review of systems with exception of occasional knee and wrist pain easily relieved with acetaminophen. Client will continue to monitor and request appointment if symptoms worsen.   Nurses’ Notes Day 1 1000:  Client admitted for severe joint pain (level of pain = 9/10), stiffness, and swelling of knees and wrists. Reports increasing pain over the last few days and being unable to walk or perform everyday tasks. Client lives alone, is on a fixed income. Client reports 2 near falls in the last 2 weeks and difficulty standing up from a sitting position due to knee stiffness and pain. Day 1 1400:  Crepitus noted on passive ROM of all extremity joints. 6 months ago:  At an annual visit client complained of “feeling their age.” States that they wished they could be as active as they used to be when in their 30s and 40s. Reports occasional knee and wrist pain, but usually relieved with rest and Tylenol. No crepitus or pain noted in joints with passive ROM at this time.   Diagnostic Results Day 1:  Admission x-rays show non-uniform joint space loss noted in ankles and hips. Subchondral stenosis noted in wrists and ankles. Wrist and ankle x-rays show small bone spurs in both wrists and right ankle.  For each potential provider order, determine if the potential prescription is anticipated, nonessential, or contraindicated for the client.  Physical therapy Fall risk precautions NSAIDS

A patient has been suffering from persistent vomiting for two days. They are diagnosed with gastroenteritis and dehydration. Measurement of their arterial blood gases shows: arterial blood gas (ABG) Lab Test – ABG Lab Value Reference Range pH 7.50 7.35 – 7.45 PaCO2 42 mmHg 35 – 45 mmHg HCO3- 34 mEq/L 22 – 28 mEq/L  PaO2 82 mmHg 80 – 100 mmHg How should the nurse interpret these results?

Ventilatory Support

Acute Respiratory Conditions

A nurse assesses a client who is admitted with an acid base imbalance. The client’s arterial blood gas values were:  arterial blood gas (ABG) Lab Test – ABG Lab Value Reference Range pH 7.32 7.35 – 7.45 PaCO2 34 mmHg 35 – 45 mmHg HCO3- 16 mEq/L 22 – 28 mEq/L  PaO2 85 mmHg 80 – 100 mmHg  The most recent ABGs show a drop in the pH. What action does the nurse take next?

Don’t forget your transaminations! Pyruvate to Alanine Oxaloacetate to Aspartate Alpha-ketoglutarate to Glutamate    

A nurse caring for a client on mechanical ventilation has double-checked the ventilator settings with the respiratory therapist. What adjustment is critical for the client’s safety?

Q10.  A client is experiencing acute chest pain. The client rates the pain as a 7 out of 10. The client’s vital signs include P 119, R 24, BP 98/63, T 99.1°F, and SpO2 89%. Which of the following actions would the nurse implement at this time?   (Select all that apply.)

Didi submits her research paper to the Journal of Retailing for publication. The editor begins the process by reading her paper and then forwards it to other members of the editorial team for additional consideration and assessment. This process is known as:

Mariah is reviewing the dataset from a survey that she conducted. She is analyzing the results from the below question and noticed that an overwhelming majority of her participants chose either “Kroger” or “Publix”. What could have happened during data collection that would lead to this result? Of the following options, where do you purchase the most groceries? Kroger Target Aldi Walmart Publix