NUR 242 Exam 3 study questions Unit 7 & 8 and well graded+answers

NUR 242 Exam 3 study questions Unit 7 & 8 and well graded+answers 1. The nurse immediately checks on the patient and finds that she appears anxious and her vital signs are as follows: ØBlood pressure: 128/84 mm Hg ØHeart rate: 114 (sinus tachycardia) ØRespiratory rate: 24, labored and restless ØTemperature: 99.4° F (axillary) ØO2 saturation: 91% on 40% O2 via trach collar Which of these findings are cause for concern?: ANS: **The BP is within normal range and only slightly elevated. **The temperature is only slightly elevated. **Her heart rate is elevated; the nurse should check the patient's medications to see if she is on a bronchodilator or other medication that could cause her heart rate to increase. The priority concern is the RESTLESSNESS with increased respiratory rate and the decreased oxygen saturation despite the 40% oxygen setting. 2. A patient with a history of chronic obstructive pulmonary disease is admit- ted with shortness of breath. Which nursing intervention is most appropriate?