Which set of vital signs should the nurse recognize as out of the expected range? Show
1. 42-year-old man: BP, 114/82; pulse, 74 beats/min; respiration, 16 breaths/min; temperature, 36.8° C 2. 11-year-old girl: pulse, 88 beats/min; respiration, 22 breaths/min; temperature, 36.7° C 3. 3-year-old boy: pulse, 130 beats/min; respiration, 44 breaths/min; temperature, 36.7° C 4. 1-month-old girl: pulse, 120 beats/min; respiration, 42 breaths/min; temperature, 36.7° C How does the nurse palpate the chest for tenderness, bulges, and symmetry? 1. Uses the fist of the dominant hand to gently tap the anterior, lateral, and posterior chest, comparing one side with another 2. Uses the ulnar surface of one hand to palpate the anterior, posterior, and lateral chest, comparing one side with another 3. With the tips of the fingers, palpates the skin over the chest and the alignment of vertebrae 4. With the palmar surface of fingers of both hands, feels the consistency of the skin over the chest and the alignment of vertebrae The nurse is charting on a patient's eye assessment and notes PERRLA. What does this stand for? correct answer is B. Some older men withdraw from intimacy due to the loss of a spouse, depression, preoccupation with work, marital or family conflicts, side effect of medication such as antihypertensives, antidepressants, sedatives, narcotics, etc., heavy alcohol use, lack of privacy (living with adult children or in a nursing home), economic or emotional stress, poor nutrition or fatigue. The nurse is calling the health care provider about a patient's changing condition. Which of the following would be included in
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Terms in this set (3)When examining a patient's cranial nerve (CN) function, the nurse remembers that the muscles in the neck that are innervated by CN XI( Spinal Accessory) are the: sternomastoid and trapezius. A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The nurse suspects damage to cranial nerve (CN) _____ and proceeds with the examination by _____. XI; asking the patient to shrug her shoulders against resistance During ocular examinations, the nurse keeps in mind that movement of the extraocular muscles is: stimulated by cranial nerves III, IV, and VI. Rationale: Students also viewedNUR102 Ch. 39 Self-Concept25 terms peckelli Chapter 15 Health Assessment quiz41 terms karencrist Chapter 1441 terms trevor50020 Chapter 21 JARVIS41 terms abk_05 Sets found in the same folderChapter 22: Musculoskeletal System51 terms Maggie_Lavery1 Chapter 09: General Survey, Measurement, Vital Sig…52 terms MsXmasPlus Chapter 19: Heart and Neck Vessels36 terms lovepink2112 Chapter 15 Health Assessment quiz41 terms karencrist Other sets by this creatorHyperparathyroidism VS Hypoparathyroidism5 terms tiffany_blackburn3 Hypothyroidism5 terms tiffany_blackburn3 Hyperthyroidism/Grave's disease7 terms tiffany_blackburn3 Addison's disease (Hyposecretion of the adrenal gl…6 terms tiffany_blackburn3 Other Quizlet setsPA State Police15 terms Baxter200178 Ch. 4 Communications and Documentation quiz20 terms Meka_EMT Bio 14049 terms theElizabeth2216 How does the nurse test the function of the patient's spinal accessory nerve CN XI?Cranial Nerve XI – Spinal Accessory
Ask the patient to turn their head to the left while resisting the pressure you are exerting in the opposite direction. At the same time, observe and palpate the right sternocleidomastoid with your left hand. Then reverse the procedure to test the left sternocleidomastoid.
How does the nurse test the function of the patient's spinal accessory nerve CN XI quizlet?Apply pressure on both shoulders. The nurse assesses Spinal Accessory nerve function by applying pressure while the client shrugs the shoulders. The nurse should check for symmetrical strength as the client shrugs the shoulders against the resistance applied.
Which would be the best test to evaluate cranial nerve xi ie spinal accessory?11th Cranial nerve
The 11th (spinal accessory) cranial nerve is evaluated by testing the muscles it supplies: For the sternocleidomastoid, the patient is asked to turn the head against resistance supplied by the examiner's hand while the examiner palpates the active muscle (opposite the turned head).
Which is a function of the accessory XI nerve quizlet?The general somatic motor function of the Spinal Accessory nerve (CN XI) is movement of the trapezius and sternocleidomastoid muscles.
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How does the nurse test the function of the patients spinal accessory nerve CN XI quizlet?
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