Ethics, Processing, and Care - NCLEX-PN

Molding, or the elongation of the infants head during labor and delivery, is a normal adaptation allowing the relatively large skull to traverse the narrow space of the birth canal. It generally resolves in 1-5 days.

The normal range for hemoglobin levels in an adult male is . Hemoglobin levels above that range may be indicative of chronic low blood oxygen, while lower levels of hemoglobin are seen in anemia.

When percussing the seventh intercostal space along the right midclavicular line, you should expect to hear a dull note, as this is directly over the solid mass of the liver.

The border of the liver can be found by percussing in a descending line along the intercostal spaces of the right midclavicular line, starting at the clavicle. The superior border of the liver can be measured at the point where percussion transforms from resonant or hyperresonant (indicating the air-filled lung) to dull (indicating the solid mass of the liver).

A healthy and normal abdominal aorta will measure between 2.5-3cm in diameter. An abdominal aorta over 3cm and under 5cm in diameter is considered to be enlarged, and surgery to prevent abdominal aortic aneurism is generally performed on abdominal aortas that surpass 5cm in diameter in females or 5.5cm in diameter in males.

Meconium is a sticky, dark-green to black stool that is the first stool passed by neonates after birth. It is composed of the content of the infant's digestive tract before it has begun drinking milk - primarily water, mucus, bile, lanugo, and intestinal epithelial cells. A newborn that has begun to feed on breastmilk or formula should pass a normal stool (yellow to mustard-green and creamy rather than sticky) within 24 hours.

A positive Murphy's sign is an indication of cholecystitis, or gallbladder inflammation. Testing for Murphy's sign is performed during an abdominal exam by asking the patient to breathe out slowly while the fingers of the examiner are slid under the right costal margin and held in place with firm pressure. The patient is then asked to inhale, which forces the abdominal contents upward. Murphy's sign is considered positive if the patient winces or flinches when breathing in, due to pain when the inflamed gallbladder comes in contact with the examiner's fingertips.

Rovsing's sign, psoas sign, and McBurney's point are all tests for appendicitis.

All of these are important professional roles of the nurse in a healthcare setting.

A nurse should expect to see an approximately 3% increase in the recipient's hemoglobin 4-6 hours after the administration of one unit of packed red blood cells.

Washed red blood cells are the product of blood that has been stripped of plasma, leukocytes, antibodies, cytokines, and platelets, in addition to any other blood proteins.

Washed red blood cells are generally prepared for patients with a history of severe allergic reaction to blood transfusion. Washed red blood cells are not generally required in patients with kidney disease, patient who are immunocompromised, or patients with metastatic disease.

Before administration, plasma products must be checked for ABO compatibility and Rh compatibility.

ABO blood type does not have to be an exact match, but blood types must be compatible. An Rh positive individual, for example, is compatible with either Rh negative blood or positive blood, while an Rh negative individual is only compatible with Rh negative blood.

In this case, the patient is able to move their biceps brachii against gravity, but they are unable to move against gentle resistance by the examiner. This means the muscle strength should be graded at .

The muscle strength grade is as follows:

: no contraction

: muscle contraction, but no movement

: movement with gravity, but not against gravity

: movement against gravity, but not against resistance

: movement against mild resistance by the examiner

: normal muscle strength

Normal levels for sodium are between . Anything below (hyponatremia) or above (hypernatremia) this is considered abnormal and should be evaluated further.

The range for normal potassium levels in blood is . Anything above that (hyperkalemia) or below that range (hypokalemia) is considered abnormal.

The normal adult reference range for blood calcium levels is .

An adult male hematocrit is considered normal when between . Anything below this may indicate anemia, elevated white blood cell count, or blood loss, while numbers above this may indicate dehydration, chronic oxygen deficiency, or a condition of excess red blood cell production (such as polycythemia vera).

Whenever possible, fresh frozen plasma should be transfused immediately (or as soon as possible) after thawing. However, if this is not possible, it may be refrigerated for as long as 24 hours after thawing.

The correct answer is "immediately inform the covering physician." This is the correct choice because in this case, a medical error was committed, and the most appropriate immediate course of action is to let the patient's covering physician know, so that they can determine what effect this may have on the patient, assess the patient, and determine what, if any, immediate intervention needs to be performed to ensure that the adverse effect on the patient is minimized.

While it is possible in this case, given that the patient has congestive heart failure, and that they may have been fluid overloaded by the administration of excess fluids, that they will need to be diuresed with furosemide, this medication cannot be administered without the order of the covering physician, and it would be inappropriate to administer furosemide without their orders.

While your hospital's safety oversight committee may ultimately need to be informed of this incident, the most immediate priority is patient safety, and as such, the patient's physician should be notified of the medical error before anyone else so that they can best manage any immediate consequences of the error.

It would be highly inappropriate to not inform anyone of the error, as an unintended dose of IV fluids was administered and this can be dangerous in a patient with congestive heart failure. Any delay, whether due to not telling anyone, or to conferring with co-nurses, in informing the supervising physician would be inappropriate and potentially dangerous to the patient.

Of the nursing types listed, only nurse practitioners are can be authorized to write prescriptions for pharmaceutical drugs.