· Appendicitis is an emergency with pain in the right lower quadrant, nausea and vomiting,

fever, leukocytosis, and anorexia. Appendicitis may be caused by obstruction, leading to

inflammation and pressure. Nursing care for appendicitis includes –
➢ Maintaining nothing by mouth (NPO) status.
➢ Initiating an intravenous (IV) catheter.
➢ Administer prescribed antibiotics and IV fluids.
➢ Preparing the client for surgery.
➢ The nurse should not administer laxatives, enemas, or apply heat to the abdomen.
The nurse should monitor for appendiceal perforation, which may manifest as a sudden,
temporary easing of pain followed by worsening. Additionally, there is increased pain with
coughing.

· Question:
The nurse is data collecting on a client with congestive heart failure. Which physical
finding should the nurse expect?
Answer:
A third heart sound, S3 gallop, is an early diastolic filling sound indicating an increase in left
ventricular pressure. This sound is often the first sign of HF. This sound is best auscultated
over the apex of the heart. If this sound is auscultated during pregnancy, this is a normal
finding.

· For a client with congestive heart failure, aerobic exercises are encouraged to maintain
the client’s strength and cardiovascular conditioning. Since congestive heart failure is a risk
factor for venous thromboembolism, the client's ambulation is essential in avoiding this
complication. When teaching a client with congestive heart failure, it is also important to
know the prescribed medication regimen involving agents such as diuretics. Adherence to
the treatment plan is critical to avoid further decline and readmission.
· Bacterium:
Group A beta hemolytic streptococcus is the most common cause of bacterial tonsillitis.
Streptococcus pneumoniae is a gram-positive bacterium that causes pneumonia; this
bacterium does not cause tonsillitis.
Group B streptococcus is a type of bacteria sometimes found in a pregnant woman’s
vagina or rectum
Neisseria meningitidis is a gram-negative bacterium that causes meningococcal diseases
such as meningitis

· Question:
Which of these would be most important to include in discharge teaching for a patient
with a platelet count of 40.000 mcL (40 x 10^9/L)?
Answer: use soft toothbrush.
This patient has thrombocytopenia and should be on bleeding precautions. Using a soft
toothbrush and flossing gently can prevent the gum tissue from bleeding. Platelets
(thrombocytes) are important for blood clotting. The normal range for platelets is 150,000-
400,000 mcL (150-400 x 10^9/L). Thrombocytopenia is a lower than normal number of
platelets (less than 150,000 platelets per microliter) in the blood. It can be inherited or
acquired.
The causes of thrombocytopenia can be classified into three groups:
>Diminished production: caused by viral infections, vitamin deficiencies, aplastic anemia, or
drug-induced
>Increased destruction: caused by drugs, heparin use, idiopathic, pregnancy, or immune
issues
>Sequestration: caused by an enlarged spleen, neonatal, gestational, pregnancy
Symptoms include:
Petechiae
Fatigue
Purpura
Prolonged bleeding cuts
Spontaneous bleeding
Jaundice
Heavy menses
Bloody stool
Enlarged spleen
Deep vein thrombosis