Patient information continued…The nurse recognizes the vit…
Patient information continued…The nurse recognizes the vital sign disturbances and quickly performs an assessment. The nurse asks the patient to smile and observes that the patient presents with a right facial droop. The nurse asks the patient to repeat the phrase “no, ifs, ands or buts about it”, he presents with an inability to speak. The daughter reports to the nurse that her father stated he had a headache earlier in the evening. Vital Signs Temperature: 98.9 F oral HR 112 bpm (reg) BP 187/98 RR 16 O2 98% Pain unable to obtain What are the objective assessment findings consistent with a diagnosis of cerebrovascular accident this patient is presenting with (Select all that apply):
Read DetailsPatient information continued… The next morning, Mr. Jones…
Patient information continued… The next morning, Mr. Jones reports feeling short of breath while getting out of bed to his chair. His vital signs are shown below. After five minutes sitting in the chair, he reported improvement in symptoms. On exam the nurse notes bilateral 2+ pitting edema in the lower extremities, crackles at lung bases bilaterally, jugular vein distention, and a third heart sound which was not noted by the previous shift. The patient is alert and oriented to person, place, and time with no evidence of dysrhythmia on telemetry monitors. The nurse evaluates the surgical incision, which appears unremarkable. Temp 97.8 F oral HR 108 bpm (reg) BP 146/92 RR 28 O2 92% Pain 3/10 Based on the above information what signs and symptoms are concerning?
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