Thermoregulation

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The nurse is assessing a patient who reports feeling weak after running outside in a temperature of 95°F (35°C). The nurse should monitor for which sign of heatstroke?

Excitability Pain Correct Confusion Loss of sensation

The nurse notes that a patient experiencing hyperthermia drank 40 oz of fluid during the previous 24 hours. Which collaborative action should the nurse expect to implement?

A cooling blanket Correct Intravenous fluids A tepid sponge bath An antipyretic

A patient tells the nurse, "My father had a severe fever from the anesthesia when he had surgery." Which diagnostic test should the nurse anticipate that the healthcare provider will order?

Magnetic resonance imaging Computed tomography Complete blood count Correct answer Caffeine halothane contracture test

The nurse is assessing a patient who was found sleeping in a park in the snow. The nurse should ask the patient about which risk factor?

Skin disorders Correct Living situation Educational level Trauma

The daughter of an 86-year-old man is concerned because her father is always complaining about being cold. Which statement by the nurse explains temperature regulation to the patient's daughter?

"Extremes in environmental temperature are well tolerated by older adults." Correct "Older adults are less efficient at regulating their body temperature." "There is less body fat and the blood vessels are closer to the skin in an older adult." "Older adults are homeothermic, stabilizing the core body temperature within a narrow range."

The nurse provided teaching to the parents of a young child who was treated for febrile seizures. The nurse provided information on how to care for the child at home. Which statement by the parents indicates effective learning?

"I need to bring my child into the emergency department as soon as the temperature is above 99°F (37.22°C)." "I should administer an antifever medication once my child's temperature goes above 101°F (38.33°C)." Correct "I should implement seizure precautions as soon as my child's temperature starts to go up." "My child is not likely to have a second febrile seizure."

A patient tells the nurse, "I feel warmer after I walk in the hall." Which response by the nurse is accurate?

"I'll check your temperature to make sure you aren't coming down with a fever." Correct "Walking uses the muscles, which produces heat." "Heat from the environment is making you feel hot." "The walk might have been too much for you to do at this time."

The nurse is assessing a child with a history of febrile seizures and notes that the child has a temperature of 101.2°F (38.4°C). How should the nurse proceed?

Insert a Foley catheter to monitor urine output. Correct Implement seizure precautions. Prepare to administer acetaminophen once the temperature reaches 102°F (38.4°C). Monitor temperature every 4 hours.

While the nurse is preparing to assess a child's temperature, the parents report that the child had ear tubes placed last year. Which site should the nurse understand is contraindicated in this patient?

Axillary Rectal Correct Tympanic membrane Oral

A patient in the third trimester of pregnancy has a fever caused by an infected hand wound. Which collaborative intervention should the nurse expect to implement?

Administering acetylsalicylic acid Administering naproxen Administering ibuprofen Correct Administering acetaminophen

A patient in the third trimester of pregnancy has a fever caused by an infected hand wound. Which collaborative intervention should the nurse expect to implement?

Administering ibuprofen Correct Administering acetaminophen Administering acetylsalicylic acid Administering naproxen

The nurse provided teaching to the parents of a young child who was treated for febrile seizures. The nurse provided information on how to care for the child at home. Which statement by the parents indicates effective learning?

CORRECT "I should implement seizure precautions as soon as my child's temperature starts to go up." "I need to bring my child into the emergency department as soon as the temperature is above 99°F (37.22°C)." "I should administer an antifever medication once my child's temperature goes above 101°F (38.33°C)." "My child is not likely to have a second febrile seizure."

The nurse is taking report for a group of patients. The nurse anticipates that which patient will need surgical debridement?

Correct A patient who is hypothermic and has black tissue on the tip of their nose An older adult patient who has a fever of unknown origin A hyperthermic athlete who passed out at practice yesterday A young child who has had a fever of 104.5°F (40.3°C) for 3 days

A patient recovering from a foot wound is resting comfortably in bed. During the last vital signs assessment, the patient's temperature was 37.5°C (101.7°F). Which action should the nurse implement?

Correct Document the assessment results. Give the patient a tepid sponge bath. Apply an ice pack to the groin. Provide a cooling blanket.

A child presents to the clinic with a fever of 38.4°C (101.1°F). The nurse should suspect which condition as being the most likely cause of the child's fever?

Correct Infection Sunburn Dehydration Overactivity

An older adult patient tells the nurse that they are always cold. The nurse understands that which physiological change is the cause of this patient's discomfort?

Correct Less efficient thermoregulation A high-fat, high-protein diet An increase in subcutaneous fat Presence of brown adipose tissue and fat

The nurse is caring for an older adult patient who has a fever and is on bedrest. Which is the priority nursing intervention for this patient?

Correct Performing a full skin assessment Administering an antipyretic according to the prn order Monitoring the patient's temperature every 30 minutes Applying ice packs to the patient's groin

The nurse is talking with a hospitalized older adult patient who reports "feeling chilly." The nurse suggests walking in the halls. What is the nurse's rationale for making the suggestion?

Correct Walking uses the muscles, which produces heat and can help to warm the patient. The hallways are warmer than the patient's room. Walking helps to strengthen muscles, which, over time, will increase thermoregulation. Walking can distract the patient from their discomfort.

Which adult body temperature should the nurse reassess and report to the healthcare provider?

Correct answer 39°C (102.2°F) 36°C (96.8°F) 37°C (98.6°F) 37.5°C (99.5°F)

A 12-month-old infant has a temperature of 102.4°F (39.1°C). Which diagnostic test should the nurse anticipate the healthcare provider to order?

Genetic testing Computed tomography of the head Magnetic resonance imaging Correct Complete blood count with differential

An unresponsive patient is brought into the emergency department after being found outside in the cold. Which is the priority intervention by the nurse?

Hanging warmed intravenous fluids Applying warming blankets Assessing the patient's skin for frostbite Correct Assessing respiratory status, oxygenation, and perfusion

The nurse is caring for a patient who is undergoing core rewarming after extreme cold exposure. The patient is still hypothermic, despite efforts to warm them up. The nurse should ask the patient's relatives about a history of which medical condition?

Heart disease Diabetes Correct answer Hypothyroidism Hyperthyroidism

The nurse is teaching a patient on how to prevent fluid imbalance while experiencing an elevated temperature. Which instruction should the nurse include in the teaching?

Ingest at least 1 L of hot fluids each day. Wear sufficient clothing to encourage sweating. Take a hot shower after spending time outdoors. Correct Drink at least 2 L of cool fluids each day.

The nurse is caring for a young child who has been hospitalized for a week with a fever of unknown origin. During this morning's vital signs evaluation, the nurse notes that the child has a temperature of 37.5°C (99.5°F). Which is the nurse's priority intervention?

Placing ice packs in the armpits and groin Correct Documenting the finding as normal Informing the healthcare provider Administering antipyretics as ordered

The nurse is caring for a patient who has severe hyperthermia and dehydration. Which diagnostic test should the nurse expect the healthcare provider to order?

Platelets Clotting factors Correct Renal function Thyroid function

The nurse assessing an 18-month-old decided not to use a tympanic thermometer. Which assessment finding led to this nursing decision?

Presence of a total body rash Occurrence of projectile vomiting Finding of irritability and crying Correct Presence of ear drainage tubes

The nurse is caring for a newborn that has a temperature of 96.9°F (36.05°C). How should the nurse help the newborn regulate its temperature?

Rapidly rewarm the child when necessary. Maintain a very warm thermal environment. Correct Maintain a neutral thermal environment. Undress the newborn and place them in a radiant warmer.

An infant has a temperature of 101.9°F (38.8°C) and is listless, fatigued, and eating poorly. Which blood test should the nurse anticipate the healthcare provider to order?

Renal function testing Albumin level Liver enzymes Correct Electrolyte levels

A patient who is scheduled for surgery tells the nurse, "I do not respond well to anesthesia and get really hot." Which action should the nurse take first?

Review the patient's white blood cell count. Correct Notify the surgeon. Document the comment in the medical record. Suggest that the surgery be cancelled at this time.

The nurse is assessing a patient who has a core body temperature of 35°C (95°F) after being found outside in the cold. How should the nurse document this finding?

Severe hypothermia Normothermia Hyperthermia Correct Mild hypothermia

The nurse is teaching a patient how to take a nonsterioidal anti-inflammatory drug (NSAID). Which instruction should the nurse provide?

Take it 2 hours after each meal. Correct answer Take it with food or a full glass of water. Take it 1 hour before checking temperature at home. Take it on an empty stomach first thing in the morning.

The nurse is assessing a patient who is critically ill with suspected hypothermia. Which site should the nurse use to take the temperature?

Tympanic membrane Correct Esophagus Temporal artery Rectum


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