A nurse is preparing to administer IV alteplase (tPA) to a c…
A nurse is preparing to administer IV alteplase (tPA) to a client experiencing an acute ischemic stroke. The client weighs 154 lb. The prescribed total dose of alteplase is 0.9 mg/kg, with a maximum total dose of 90 mg. Ten percent (10%) of the calculated total dose is administered as an IV bolus over 1 minute, with the remaining 90% administered by continuous IV infusion. Question: What bolus dose, in milligrams (mg), should the nurse administer? Numeric value only; round to the nearest tenth.
Read DetailsA patient is admitted with an acute COPD exacerbation and re…
A patient is admitted with an acute COPD exacerbation and receives prescribed bronchodilators, systemic corticosteroids, controlled oxygen therapy, and noninvasive ventilation. Four hours later, the nurse obtains the following findings. For each finding, identify whether it indicates improvement, no meaningful improvement, or worsening in their clinical condition. Clinical Finding Clinical Indication Respiratory rate decreases from 32 to 24/min SpO₂ increases from 84% to 90% on prescribed oxygen PaCO₂ decreases from 68 to 58 mm Hg (ref: 35 – 45 mmHg) Patient becomes increasingly somnolent Accessory muscle use decreases Breath sounds remain diminished bilaterally pH increases from 7.27 to 7.33 (ref: 7.35 – 7.45)
Read DetailsAt 1500, R.T. has been intubated and placed on mechanical ve…
At 1500, R.T. has been intubated and placed on mechanical ventilation. Two hours later, the nurse reassesses his response to mechanical ventilation. For each finding, identify whether the change represents an improvement or requires continued monitoring because the underlying condition remains present. Finding Before Intubation 2 Hours After Intubation Clinical Significance SpO₂ 84% on FiO₂ 100% HFNC 94% PaO₂ 48 mm Hg 72 mm Hg pH 7.26 7.35 PaCO₂ 52 mm Hg 44 mm Hg Heart rate 126/min 104/min Blood pressure 94/56 mm Hg 108/64 mm Hg Temperature 102.4°F 102.6°F Breath sounds Diffuse crackles Diffuse crackles Work of breathing Severe Decreased Mechanical ventilation Not receiving Continues to require ventilatory support
Read DetailsA 68-year-old patient arrives in the emergency department 90…
A 68-year-old patient arrives in the emergency department 90 minutes after the sudden onset of right-sided weakness and expressive aphasia. A noncontrast CT scan shows no evidence of intracranial hemorrhage. The patient is being evaluated for IV fibrinolytic therapy. Current vital signs: BP: 192/108 mm Hg HR: 84/min RR: 18/min SpO₂: 98% on room air Which action should the nurse anticipate, based on the included information?
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