One of the medications on Mr. Gibbs’ medication administration record is for morphine 2 to 4 mg IV every 2 hours PRN for pain. The last dose of 3 mg was given to Mr. Gibbs 2 hours ago, and he is in bed with his eyes closed. The nurse notes a heart rate of 86 beats/min and a respiratory rate of 8 breaths per minute. Which PRN medication will the nurse give this patient?

Ms. Jernigan’s pedal edema is likely caused by which of the following?

Ms. Murray’s autonomic status will result in which of the following?

Which electrolyte abnormality is most concerning for Mr. Thomas’ immediate safety, and why?

Ms. Jernigan has been taking the anticoagulant Coumadin. Which of the following indicates therapeutic anticoagulation on this medication?

What is the most likely reason for her clinical manifestations of bruising and nosebleeds?

Mr. Gibbs’ myocardial hypertrophy may be caused by which of the following?

Barbara Ewing is an 86-year-old female with a recent history of poor appetite, difficulty swallowing, and weight loss  Her medical history includes hypertension and coronary artery disease managed by medications and a stroke several years ago leaving her with left sided weakness and inability to walk  She is very shaky and has notable tremors of her upper extremities when she moves her arms. Atrophy of the left arm and leg is noted.  Ms. Ewing typically sits in a wheelchair most of the day, however lately she has felt too weak and has been staying in bed most of the time  Skin breakdown has developed on her coccyx and elbows with notable erythema, edema, warmth, tenderness, and yellow drainage  Ms. Ewing has not been able to rate her coccygeal pain using a pain scale, however she moans, cries, and pushes you away when her coccyx is touched  Otherwise, Ms. Ewing has intact, dry skin and mucous membranes, pitting edema of both legs and feet, and scant urine output.  Vital signs are:  38.7, 112, 26, 96/44.  The following laboratory values were assessed: Serum Electrolytes Na 155 mEq/L Cl  106 mEq/L K 2.9 mEq/L BUN     18 mg/dL Creatinine 1.1 mg/dL  CO2 19 mmol/L Ca        7.9 mg/dL Mag     1.7 mEq/L Phosphorous   4.7 mg/dL Glucose         185 mg/dL                Albumin   2.9 g/dL                          Lactic Acid   6.0 mEq/L  

Ms. Murray develops acute hypoxemia and a decreased level of consciousness. A subsequent ABG is ordered and drawn with the following results:  PaO2 – 50 mm Hg, pH 7.2, PaCO2 – 52 mm Hg, HCO3 – 24meq, and SaO2 – 80%, indicating which of the following?

Sustained hypoxia has the potential to result in which of the following?