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Which assessment finding is most important for the nurse to monitor during initial fluid resuscitation of a seriously burned client?

A nurse is caring for a client who is receiving TPN. The current bag was hung 25 hrs ago and still has 300ml to infuse. Which of the following is the appropriate action for the nurse to take?

A patient presents to the ER with reports of decreased urine output and some swelling in their legs x 2 days. The nurse is performing a health history and assessment on the patient. Which of the following are concerning to the nurse for the development of AKI?   SELECT ALL THAT APPLY

A 83 y/o patient with a history of CHF, Atrial fibrillation, hypertension, and Diabetes arrives at the ER with complaints of dyspnea on exertion, swelling of his extremities, and fewer “trips to the bathroom”. Assessment reveals BP 174/96, HR 112 A.fib, RR 22, Temp. 100.4 and breath sounds reveal crackles throughout all fields. After initial treatment of IV Furosemide 80 mg, the nurse evaluates treatment is effective when she notes:

An elderly patient is scheduled for a CT scan with contrast. The nurse would anticipate the following to help prevent renal damage? (Select All that Apply)

A patient admitted with sepsis has had several episodes of severe hypotension. Lab results indicate a BUN of 30 mg/dl and serum creatinine of 2.0 mg/dl. The urinalysis reveals cellular casts and debris indicating sloughing of cells. The nurse knows these findings are consistent with:

A patient sustained electrical burns after an industrial accident 12 hours ago. The RN caring for the patient evaluates he is experiencing further complications when she identifies:  SELECT ALL THAT APPLY:

Cardiac monitoring is initiated for a patient with Acute Kidney Injury. The nurse recognizes that this measure is important to identify:

Which of the following is the priority nursing intervention for a patient with diabetic ketoacidosis?

A client who has massive trauma is admitted to the ICU. Which pathophysiologic event associated with trauma would cause the nurse to intervene to protect the client’s immune system?