For the next following questions consider this scenario: You…

For the next following questions consider this scenario: You are the nurse assigned to a 55-year-old client admitted for mild dehydration. Your instructor asks you to perform a head-to-toe assessment. You note the client’s posture, level of consciousness, and overall appearance. The client is alert but looks fatigued. Which observation is most important to document in the general survey?  

Which of the following are unexpected findings when completi…

Which of the following are unexpected findings when completing an assessment? Select All That Apply ————————————————————————————————————   Client is awake, alert, diaphoretic when sitting upright. Client reports having difficulty catching their breath especially when going up steps. Pupils are equal, round, and reactive to light and accommodation (PERRLA). Mucus membranes are pink and moist. Nail-beds are pink, no clubbing noted, and capillary refill is 2 seconds. Bilateral lower extremity +2 edema is present.  S1, S2, and S3 heart sounds noted. Crackles are heard bilaterally to lung fields Abdomen is soft, no tenderness or masses noted. Bowel sounds are present in all quadrants. Oxygen saturation 93%