When working with English Learners and children from different linguistic backgrounds, it is important for teachers to do all of the following except:

What does HQIM stand for?

The nurse is caring for a client with suspected acute tubular necrosis (ATN) who has developed acute renal failure. The nurse is reviewing the client’s ABG results and notes which ABG results to be most likely based on the diagnosis of acute renal failure?

The nurse is suctioning a client through the endotracheal tube. During suctioning, the nurse notes cardiac irregularities on the monitor. Which of the following is the most appropriate nursing intervention?

The nurse is caring for a client admitted to the intensive care unit (ICU). The client’s arterial blood gas (ABG) revealed the following: pH – 7.30, PaCO2 – 44, HCO3 – 20, PaO2 – 78.Determine the compensation status, acid-base imbalance, and the oxygenation status (hypoxemic/low, adequate/normal, overoxygenated/high) from the choices below. 

The nurse receives a 72-year old female who is admitted to the medical intensive care unit (MICU) from the general medicine floor in respiratory distress. The MICU nurse learns from the floor nurse that the client was admitted two days prior for aspiration pneumonia from a nursing home and has been receiving antibiotic treatment since admission.MICU Nursing notes:0800: Client arrives to the ICU in respiratory distress on 15L oxygen via a non-rebreather mask after no improvement in oxygenation status on 12L high-flow nasal cannula on the general medicine floor. Client appears to have labored breathing and accessory muscle use. Fine crackles are auscultated bilaterally in the upper and lower lobes. Client is diaphoretic, restless, and minimally following commands. Vital signs taken, Labs drawn, EKG, and Chest x-ray done at bedside.Vital Signs upon arrival to MICU: T – 100.4’FHR – 125 – sinus tachycardiaRR – 38BP – 165/78 (MAP 110)SpO2 – 87% on 15L non-rebreather mask.Pertinent Laboratory Results:WBC11,500 mcL (5,000-10,000 mcL)Hgb11.5 g/dL (14-18 g/dL in men and 12-16 g/dL in women)K+4.1 mEq/L (3.5-4.5 mEq/L)Na+138 mEq/L (135–145 mEq/L)Mg1.6 mEq/L (1.5-2.0 mEq/L)ABG Results on 15L Non-Rebreather Mask:pH7.28PaO255 mmHgPaCO265 mmHgHCO3-30 mEq/LLactic acid3.0 mmol/L (0.5-2.2 mmol/L)Imaging:Electrocardiogram: Sinus TachycardiaCXR: Bilateral diffuse pulmonary ground glass opacities consistent with pulmonary edema

Based on the current client data above, which intervention would the nurse anticipate?

The nurse is aware that pulmonary edema will lead to an alveolar dead space VQ mismatch.  

The nurse is monitoring a client who is being weaned from mechanical ventilation by a trial of spontaneous breathing. The client, prior to weaning, had a blood pressure of 126/70, heart rate of 72, and respiratory rate of 12. Which of the following signs or symptoms would best indicate the client is not tolerating the weaning process?

A client is to be dialyzed within the next three hours. The client has an order for 20mg of propranolol (Inderal) in two hours. In order to prevent hypotension during dialysis, the nurse should: