Week 3: Thermoregulation EAQ
A client's temperature is 100.4° F (38° C) 12 hours after a spontaneous vaginal birth. What does the nurse suspect is the cause of the increased temperature?
Dehydration
Which symptoms are common during the fulminant stage of inhalation of anthrax? Select all that apply.
Dyspnea Diaphoresis High temperature
The nurse assesses for what client symptoms that indicate hyperthermia? Select all that apply.
Vasodilation Dry and flushed skin Decreased urinary output
An older adult with a history of diabetes reports giddiness, excessive thirst, and nausea. During an assessment, the nurse notices the client's body temperature as 105° F. Which condition does the nurse suspect in the client?
Heat stroke
An older adult with chills arrived to hospital. The nurse assesses the client's vital signs and determined the client has a fever. What would be the client's rectal temperature?
38.5ºC
The nurse tells a client undergoing diuretic therapy to avoid working in the garden on hot summer days. What condition is the nurse trying to prevent in this client?
Heatstroke
A client with multiple myeloma who is receiving chemotherapy has a temperature of 102.2° F (39° C). The temperature was 99.2° F (37.3° C) when it was taken 6 hours ago. What is a prioritynursing intervention in this case?
Administer the prescribed antipyretic and notify the primary health care provider.
A pediatric client with a past history of chicken pox reports a fever and headache. Which drug should the nurse avoid giving to the client?
Aspirin
The nurse is measuring the body temperature of four clients in a clinical setting. Which client is in need of rewarming through cardiopulmonary bypass?
Client B
The nurse is reviewing the blood test reports of a child whose blood sample was tested after receiving a general anesthetic. The nurse finds that the client has increased intracellular calcium levels. What medication would be beneficial to the client?
Dantrolene (Dantrium)
While assessing a neonate's temperature, the nurse observes a drop in the body temperature. What is the mostappropriate reason for this temperature drop?
Decreased nonshivering thermogenesis
What are the clinical manifestations of inhalation anthrax? Select all that apply.
Fever Fatigue Dry cough
Which parts of the body assessed by the nurse would confirm a diagnosis of frostbite? Select all that apply.
Fingers Ear lobes
Which is a characteristic of the glands that secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action?
Grow in conjunction with axillary hair follicles
A client with a head injury underwent a physical examination. The nurse observes that the client's temperature assessments do not correspond with the client's condition. An injury to which part of the brain may be the reason for this condition?
Hypothalamus
What is the focus of nursing care for a newborn with respiratory distress syndrome (RDS)?
Keeping the infant warm to maintain body temperature at 98° F (37° C)
The nurse is measuring the body temperature of four neonates born at term in a pediatric health setting. Which neonate has normal body temperature?
Neonate 3
A nurse is caring for a mother and neonate. What is the priority nursing action to prevent heat loss in the neonate immediately after birth?
Putting the naked newborn on the mother's skin and covering the infant with a blanket
The nurse cares for an unconscious client who underwent head surgery. Which site would be best used to monitor body temperature?
Rectal
While assessing a client with chills and fever, the nurse observes that the febrile episodes are followed by normal temperatures and that the episodes are longer than 24 hours. Which fever pattern does the nurse anticipate?
Relapsing
On the day after surgery for insertion of a ventriculoperitoneal shunt to treat hydrocephalus, an infant's temperature increases to 103.0° F (39.4° C). The nurse immediately notifies the practitioner. What is the next nursing action?
Removing excess clothing from the infant
During the assessment of a preterm neonate the nurse determines that the infant is experiencing hypothermia. Which action should the nurse take?
Rewarm gradually
Which body temperature measurement sites would be considered safe, inexpensive, and least invasive? Select all that apply.
Skin Axilla
The nurse is caring for a client who reports dizziness, excessive thirst, and nausea. Which assessment parameter should make the nurse suspect this client may be suffering from heat stroke?
Skin that is hot and dry to the touch
A client experiencing chills and fever is admitted to the hospital. After assessing the client's vitals and medical history, the nurse concluded that the client's fever pattern is remittent. Which assessment finding led to this conclusion?
The client's fever spikes and falls without a return to normal temperature levels