During a Visit to the Home of a Patient with Heart

question 28

Multiple Choice

During a visit to the home of a patient with heart failure and diabetes the nurse learns that the patient "feels strange." Data collected includes blood pressure 172/94 mm Hg,pulse 112 beats/min,respirations 22/min; heart rhythm regular; coarse crackles in lower lung bases.What action should the nurse take?

• A) Consult the RN.
• B) Give the patient orange juice.
• C) Assist patient to bed for a nap.
• D) Recheck vital signs in 30 minutes.

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Definitions:

Bladder

A hollow muscular organ that stores urine from the kidneys before it is excreted through urination.

Renal Pelvis

The funnel-shaped structure in the kidney that collects urine from the kidney and channels it to the ureter.

Inflammation

A response of body tissues to injury or infection, often marked by redness, heat, swelling, and pain.

mm

Millimeter, a unit of length in the metric system equal to one thousandth of a meter.