Nursing 211

N211: Health Differences Across the Lifespan I a. Rationale: Hormones related to anxiety stimulate the sympathetic nervous system, causing a stress response that increases cardiac workload. Measures to reduce anxiety will decrease oxygen demand, which should relieve pain as well. 54. May produce insomnia a. Rationale: Inderal, a beta blocker, can produce insomnia in conjunction with mental depression 55. “I use laxatives as needed, to keep stools soft.” 56. Insufficient coronary blood flow a. Rationale: Coronary insufficiency results in a decreased oxygen supply to meet increased myocardial demand for oxygen in response to a physical condition or emotional stress. 57. Fowlers 58. The child refuses to drink fluids a. Rationale: Oral hydration is of highest importance during painful sickle cell crisis. 59. Digoxin (Lanoxin) (strengthens myocardial contraction, thus increasing cardiac output. 60. “I will avoid outdoor activities when the temperatures are extreme.” a. Rationale: Exposure to cold, in particular, leads to increased oxygen demand, as does exercise. The patient should be encouraged to exercise but to avoid adding the stress of extremes in temperature. 61. Muscle weakness a. Rationale: Muscle weakness is a symptom of hypokalemia, which occurs in patients taking diuretics like Lasix that deplete potassium. 62. “When my pacemaker needs checking, I can have it checked over the telephone.” 63. Review coagulation times a. Rationale: To monitor the effectiveness of a transfusion, a platelet count is usually ordered one hour afterwards, and the data on coagulation times reviewed. 64. Weight gain of two pounds over a couple of days a. Rationale: May indicate a worsening condition 65. Dependent edema a. Rationale: Dependent edema is a key indicator of right sided ventricular failure 66. Cigarette smoking promotes platelet aggregation, resulting in blood clot formation in the heart. 67. Cereals (iron fortified cereals and formula) 68. Support the lower arms and pillows when the head of the bed is elevated 30º a. Rationale: This intervention decreases the workload of the heart. 69. Disseminated intravascular coagulation (DIC) a. Rationale: In disseminated intravascular coagulation (DIC), normal hemostatic mechanisms are altered and many tiny clots form in the microcirculation. 70. Serum potassium level 3.0 mEq/L a. Rationale: This potassium level is below the normal range of 3.5 to 5.0 mEq/L. Hypokalemia can cause dysrhythmias and even cardiac arrest. 71. Discuss the side effects of the medication and potential for an alteration in sexual function.


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