Emergency and Newborn Assessment Quiz

Emergency Department Assessment

• A 75-year-old woman presents with "not feeling well" and multiple concerning vital signs
  • Blood pressure: 145/95 mmHg
  • Pulse: 85 bpm
  • Respirations: 24 breaths/min
  • Blood sugar: 300 mg/dL
• The nurse notes an open wound on the patient's foot, but the patient is unaware of it
• This indicates a potential sensory impairment, likely related to diabetes
• Diabetes can cause decreased sensation in the extremities
• The high blood sugar level further supports this diagnosis
• Antihypertensive medications don't typically cause decreased skin sensation
• It's important to rule out cognitive impairment

Newborn Hearing Screening

• The nurse discusses the importance of hearing screening in newborns
• The primary rationale is to identify hearing loss early and provide interventions to promote language development

Adult Male with Decreased Appetite

• A male patient complains of decreased appetite after completing antibiotics for pneumonia
• This is a common side effect of antibiotics
• This is not related to altered sense of smell, fluid intake, or positioning

Home Health Care: Eardrops

• A patient receiving home health care demonstrates a misunderstanding of eardrop administration
• Refrigerating eardrops can cause dizziness due to stimulating the semicircular canals
• Other aspects of eardrop administration are correct: leaving the ear wick in place, holding the dropper above the ear, and lying down before and after administration

Older Patient with Hearing Loss

• An older patient repeatedly requests the nurse to "speak up"
• The appropriate nursing action is to speak normally but more slowly
• Increasing volume, overenunciating, and using exaggerated facial expressions are not effective

Patient with Presbycusis and Binaural Hearing Aids

• A patient with presbycusis (age-related hearing loss) is fitted with binaural hearing aids
• Initially, the patient should experiment with the aids in a quiet environment, adjusting the volume as needed
• Both hearing aids should be used simultaneously

Cochlear Implant Considerations

• Information to include for a patient considering a cochlear implant:
  • Cochlear implants are surgically implanted devices
  • They provide a sensation of hearing for individuals with severe or profound sensorineural hearing loss

Prevention of Childhood Hearing Loss

• The most common cause of hearing impairment in children is chronic otitis media
• It's vital for parents to understand the importance of treating ear infections promptly and preventing recurrences

Patient with Hypokalemia

• A patient taking a potassium-wasting diuretic for hypertension complains of generalized weakness
• This indicates potential hypokalemia
• The nurse should alert the health care provider immediately
• A basic metabolic panel is essential to confirm the diagnosis and monitor potassium levels

Spironolactone (Aldactone) Teaching

• A patient taking spironolactone, a potassium-sparing diuretic, should prioritize low-potassium foods to avoid hyperkalemia
• Examples of low-potassium foods include apple juice
• Avoid salt substitutes, which are high in potassium
• Increase fluid intake is not recommended for a patient taking a diuretic

New-Onset Confusion and Hyponatremia

• A patient with new-onset confusion and hyponatremia should be placed near the nurse's station for close monitoring
• The nurse should avoid placing the patient near a water fountain as water intake is typically restricted to help improve sodium levels

IV Potassium Chloride (KCl) Administration

• When administering IV potassium chloride, the nurse should prioritize monitoring lung sounds
• Hypertonic solutions can cause water retention and may lead to pulmonary edema
• Other important assessments include peripheral pulses, peripheral edema and urinary output

Effectiveness of Protein Supplements

• A long-term care resident with a low serum total protein level is receiving protein supplements
• Decreased peripheral edema indicates an improvement in the patient's protein status

Assessing Acid-Base Balance

• A patient presents with lethargy, deep rapid respirations, and the following ABG results:
  • pH 7.32
  • PaO2 88 mmHg
  • PaCO2 37 mmHg
  • HCO3 16 mEq/L
• These results indicate metabolic acidosis

Hypokalemia and Digoxin Toxicity

• A patient on diuretic therapy presents with a serum potassium level of 3.0 mEq/L
• The nurse should immediately alert the health care provider about the patient's digoxin (Lanoxin) medication
• Hypokalemia increases the risk of digoxin toxicity, which can cause dangerous dysrhythmias

Hypercalcemia

• A patient has a calcium level of 12.1 mg/dL
• This indicates hypercalcemia, which needs to be addressed by the healthcare provider

Test your knowledge on emergency department assessments, including patient presentations like diabetes complications and the significance of newborn hearing screenings. This quiz will challenge your understanding of vital signs, sensory impairments, and early detection in infants.