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T.A., a 54-year-old Hispanic man, presented to the emergency department with shortness of breath, fever, and a cough that has lasted several days. T.A. is being admitted to the medical unit for treatment of pneumonia and hyperglycemia. He has a history of hypertension and type 2 diabetes (T2DM). He has been taking the following medications: Metformin 500 mg PO BID; last dose last night Lisinopril 20 mg PO daily; last dose yesterday morning  Subjective Data Reports that his home glucometer was lost recently. Reports frequent urination and thirst. Smokes one pack of cigarettes a day. Has sharp pain in the right lower chest upon inspiration. Rates pain as a 6 on a scale of 1 to 10. Objective Data Physical Examination Temperature 38.5˚C, pulse 118, respirations 26, blood pressure 136/92 Oxygen saturation 91% on room air Awake and alert, oriented x 4 Weight 86 KG Respirations symmetrical, slightly labored on any exertion, coarse crackles right lower lobes Cough productive of thick yellow sputum Diagnostic Studies Lab values Glucose 788 mg/dL ABG- Ph 7.36, CO2 35, HCO3 18 Hemoglobin A1C 9.2% NA 150 (135-145 meq/L), K 5.4 (3.5-5.2 meq/L), Cl 110 (96-106 meq/L), Mag 1.5 (1.7-2.2 mg/dl) Chest radiography: infiltrates- right lower lobe Which of the following orders will you implement? Choose ALL that apply.

A client has newly diagnosed systemic lupus erythematosus (SLE). What instruction by the nurse is most important?

A patient in the ICU presents with wheezing, stridor, flushing, pruitis, angioedema and anxiety and a blood pressure of 76/50, Which of the following medications would be anticipated in the treatment of this patient? (Select all that apply)

R.B. is a 55-year-old woman who presented to the emergency department (ED) via ambulance for acute shortness of breath. Her daughter called an ambulance after finding her mother with an increased respiratory rate and shortness of breath. Upon arrival to the ED, R.B.’s respirations were 40 and shallow with wheezing in the lower lobes and rhonchi in the upper lobes bilaterally. She had positive jugular vein distention and a heart rate of 128. After treatment with albuterol nebulizer via mask, her vital signs were temperature 96.8˚F, pulse 98, respirations 28, blood pressure 148/84, and O2 saturation 94% with 15 LPM via mask. Arterial blood gasses showed her pH 7.19, pCO2 90, PO2 92%, HCO3 38. R.B. was intubated for hypercapnia. After an echocardiogram showed an ejection fraction less than 50%, she had an emergency left heart catheterization done with 2 stent placements into the left anterior descending artery. A pulmonary artery catheter was placed, and the initial hemodynamic readings show elevated left ventricular preload. R.B. is now being transferred to the intensive care unit (ICU).  Subjective Data Lives with her single daughter, who cares for D.B. full time Daughter is not present at bedside Smokes 1 pack of cigarettes per day No longer active outside of the home because of her chronic illness Does not drink alcohol  Objective Data Physical Assessment Orally intubated #8 endotracheal (ET) tube taped at 26 cm to lip Ventilator settings: FIO2 60%, tidal volume 600, assist control (A/C), rate 16, PEEP of 5 Height 5’5″, weight 117 kg Alert and oriented to person, place, and time Fine crackles and wheezes bilateral lower lobes 2+ pitting edema bilateral lower extremities Diagnostic Studies Chest x-ray postintubation: ET tube 4 cm from carina. Infiltrates in both bases; left base is worse than right 12-lead ECG: ST elevation Troponin: 41.94 Lung V/Q scan negative for pulmonary embolism Urinalysis: dark yellow and cloudy, protein 28 mg/dL, positive for casts, positive for red blood cells and white blood cells, positive for glucose and ketones Question; what nursing interventions are needed to prevent ventilator associated pneumonia (VAP)? Choose ALL that apply.

An HIV-positive client is admitted to the hospital with Toxoplasma gondii infection. Which action by the nurse is most appropriate?

R.B. is a 55-year-old woman who presented to the emergency department (ED) via ambulance for acute shortness of breath. Her daughter called an ambulance after finding her mother with an increased respiratory rate and shortness of breath. Upon arrival to the ED, R.B.’s respirations were 40 and shallow with wheezing in the lower lobes and rhonchi in the upper lobes bilaterally. She had positive jugular vein distention and a heart rate of 128. After treatment with albuterol nebulizer via mask, her vital signs were temperature 96.8˚F, pulse 98, respirations 28, blood pressure 148/84, and O2 saturation 94% with 15 LPM via mask. Arterial blood gasses showed her pH 7.19, pCO2 90, PO2 92%, HCO3 38. R.B. was intubated for hypercapnia. After an echocardiogram showed an ejection fraction less than 50%, she had an emergency left heart catheterization done with 2 stent placements into the left anterior descending artery. A pulmonary artery catheter was placed, and the initial hemodynamic readings show elevated left ventricular preload. R.B. is now being transferred to the intensive care unit (ICU).  Subjective Data Lives with her single daughter, who cares for D.B. full time Daughter is not present at bedside Smokes 1 pack of cigarettes per day No longer active outside of the home because of her chronic illness Does not drink alcohol  Objective Data Physical Assessment Orally intubated #8 endotracheal (ET) tube taped at 26 cm to lip Ventilator settings: FIO2 60%, tidal volume 600, assist control (A/C), rate 16, PEEP of 5 Height 5’5″, weight 117 kg Alert and oriented to person, place, and time Fine crackles and wheezes bilateral lower lobes 2+ pitting edema bilateral lower extremities Diagnostic Studies Chest x-ray postintubation: ET tube 4 cm from carina. Infiltrates in both bases; left base is worse than right 12-lead ECG: ST elevation Troponin: 41.94 Lung V/Q scan negative for pulmonary embolism Urinalysis: dark yellow and cloudy, protein 28 mg/dL, positive for casts, positive for red blood cells and white blood cells, positive for glucose and ketones Question; while you are charting, you hear vent alarms going off. You see the patient struggling, there is no obvious cause. What is your priority action?

On admission to the burn unit, a patient with an approximate 25% total body surface area (TBSA) burn has the following initial laboratory results: Hct 56%, Hb 17.2 mg/dL (172 g/L), serum K+ 4.8 mEq/L (4.8 mmol/L), and serum Na+ 135 mEq/L (135 mmol/L). Which action will the nurse anticipate taking?

In one lecture, I read two poems to you. In the first poem, which of the following gifts does the Shepherd promise to give the Shepherdess?

What game do Utopians play for recreation? 

In one of the lectures, I mentioned one of the following novels as an example of a dystopian work?