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A nurse is assessing a client's respiration. Which of the following actions should the nurse take?
Elevate the head of the clients bed 45-60 degrees
This is a comfortable position for most clients and it allows full ventilatory movement.
Discomfort can increase a client's respiratory rate.
A nurse is preparing to record the difference between a clients sys and diastol BP. WHich of the
following terms defines this info when documenting Pulse Pressure
The difference between the systolic and diastolic pressures is the pulse pressure. If the client's
blood pressure is 130/85 mm Hg, the pulse pressure is 45 mm Hg. Pulse pressure can be a
predictor of heart conditions, especially in older adults. For example, an elevated pulse
pressure usually reflects stiffness and reduced elasticity of the aorta, most often due to
hypertension or atherosclerosis.
A nurse is measuring a clients temp orally. Which of the following actions should the nurse
take? Place the probe in the posterior lingual pocket lateral to the midline
The heat produced by superficial blood vessels in the right and the left posterior sublingual
pocket is what generates an accurate oral temperature reading. Inserting the probe "sideways"
into the back of the area under the tongue on the left or the right will access this area.
A nurse is collecting data about a clients respiratory condt. Which of the following actions
should the nurse take to determine the depth of the clients respiration? Observe the degree
of chest wall movement during inspiration and expiration
The nurse can determine the depth of respiration subjectively by evaluating how much chest-
wall movement is observed. The movement is generated by the movements of the diaphragm
and intercostal muscles as the client breathes. With shallow respiration, the nurse will observe
A nurse is assessing a client's respiration. Which of the following actions should the nurse take?
Elevate the head of the clients bed 45-60 degrees
This is a comfortable position for most clients and it allows full ventilatory movement.
Discomfort can increase a client's respiratory rate.
A nurse is preparing to record the difference between a clients sys and diastol BP. WHich of the
following terms defines this info when documenting Pulse Pressure
The difference between the systolic and diastolic pressures is the pulse pressure. If the client's
blood pressure is 130/85 mm Hg, the pulse pressure is 45 mm Hg. Pulse pressure can be a
predictor of heart conditions, especially in older adults. For example, an elevated pulse
pressure usually reflects stiffness and reduced elasticity of the aorta, most often due to
hypertension or atherosclerosis.
A nurse is measuring a clients temp orally. Which of the following actions should the nurse
take? Place the probe in the posterior lingual pocket lateral to the midline
The heat produced by superficial blood vessels in the right and the left posterior sublingual
pocket is what generates an accurate oral temperature reading. Inserting the probe "sideways"
into the back of the area under the tongue on the left or the right will access this area.
A nurse is collecting data about a clients respiratory condt. Which of the following actions
should the nurse take to determine the depth of the clients respiration? Observe the degree
of chest wall movement during inspiration and expiration
The nurse can determine the depth of respiration subjectively by evaluating how much chest-
wall movement is observed. The movement is generated by the movements of the diaphragm
and intercostal muscles as the client breathes. With shallow respiration, the nurse will observe
