In the following diagram, the larynx is indicated by: 30(1).jpg

You are administering heparin and following the protocol below for a client weighing 189 lbs. The order is to administer an initial heparin bolus IV followed by a titrated IV infusion. Round to the tenths place. HEPARIN PROTOCOL Initial bolus- 50 units/kg Initial rate – 18 units/kg/h Obtain a PTT every 6 hours, and adjust dosage and rate as follows: If  PTT is less than 35 secs:      Repeat bolus with 80 units/kg and increase the rate by 4 units/kg/h If  PTT is 36 to 44 seconds:       Repeat bolus with 40 units/kg and increase the rate by 2 units/kg/h If  PTT is 45 to 75 seconds:       Continue current rate. If  PTT is 76 to 90 seconds:       If  PTT is 76 to 90 seconds: Decrease rate by 2 units/kg/h If  PTT is greater than 90 secs: Hold the heparin for 1 hour and decrease rate by 3 units/kg/h Available (for bolus)  – heparin 1,000 units/mLAvailable (for infusion) –  heparin 25,000 units in 250 mL D5W  6 hours later the PTT results from the lab are- PTT 100 secs for this patient. The client is currently receiving 20units/kg/h After HOLDING the infusion for 1 hour.  What rate will the nurse set the pump at for the titrated heparin IV infusion in response to the PTT of 100 secs?

The priority focused assessments for the client who is receiving a heparin infusion include which of the following? SELECT ALL THAT APPLY

A client has been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? 

A nurse is initiating a blood transfusion of PRBC to a client. Initial vital signs are: T 98.6°F, P 66 bpm, RR 16 bpm, B/P 115/72 mmHg, and Pulse Oximetry 98% on room air. After 15 minutes, the nurse rechecks the vital signs and notes the following changes: T 99.8°F, P 72 bpm, RR 18 bpm, B/P 118/76 mmHg, and Pulse Oximetry 98% on room air. Based on this assessment data, the nurse suspects a blood transfusion reaction is most likely occurring. Based on this condition which two interventions in priority order should the nurse take?   Which two priority parameters/manifestations should the nurse monitor ?    

A client who is being treated for cancer presents with periorbital edema, jugular distension, dyspnea, and cough. The nurse understands these are cardinal signs of which of these following oncologic emergencies?

A client returns to the unit following a right modified radical mastectomy and axillary dissection of lymph nodes. The priority intervention for the nurse implements which priority intervention upon the client’s return to the unit?  

A client is being admitted with a tentative diagnosis of Acute Myeloid Leukemia (AML).  The nurse educates the client on diagnostic testing and explains the expected plan would include which testing to confirm the diagnosis?   

The client with benign prostatic hyperplasia has undergone a transurethral resection of the prostate (TURP) and is asking why he needs to have a continuous bladder irrigation (CBI), The nurse’s best response to the client’s question would be to explain the need for CBI with which of the following statements?

 Fernando doesn’t cut in line, raises his hand in class before talking, and stops his car at stop signs on the road. He focuses on conventional rules that have been established by social consensus in order to control behavior and maintain the social system. Which of the following best describes Fernando’s reasoning?