The 75-year-old patient presents to the emergency department complaining of a severe headache that is localized behind the right eye. The patient is nauseous and vomits upon standing. While wearing glasses, the visual acuity is 20/25 in the left eye and 20/110 in the right (records show it is normally also 20/25 corrected). Her left pupil is equal, round, and reactive to light and accommodation; it is measured at 3 mm. Her right pupil reacts only minimally to light and measures at 5 mm; it is round. The provider palpates the eye and reports that it is tense. Her heart rate is 102 bpm and blood pressure is 118/84 mmHg. The nurse anticipates providing which intervention first?
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- Physiological Adaptation
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- Category: Physiological Adaptation
- Difficulty: 5
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Additional Physiological Adaptation Questions
- Question Type: Multiple Choice - Select One
- Difficulty: 10
The unresponsive patient is found to have the following heart rhythm on electrocardiogram (ECG). Which initial intervention is appropriate?
- Question Type: Multiple Choice - Select One
- Difficulty: 7
A client with an intracranial hemorrhage has a sudden increase of 25 mmHg intracranial pressure. The nurse also notes an elevated temperature, increased blood pressure, fixed and dilated right pupil, loss of consciousness, and irregular pulse and respirations. Which condition does the nurse suspect is causing these signs and symptoms?
- Question Type: Multiple Choice - Select One
- Difficulty: 3
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