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The client has piloerection on the arms and legs and diaphoresis on the forehead. Client is wearing new, low-top athletic shoes purchased by the client’s parents instead of prescribed foot splints. During abdominal palpation, a semi- firm mass is noted in the left lower quadrant(LLQ). Bladder is nonpalpable. History and Physical: Vital Signs110 T 99.0\deg F (37.2\deg C) P 56 RR 18 BP 192/102 Pulse oximetry reading 97% on mechanical ventilation. The nurse has collected data from the client. Which of the following would require immediate follow-up? A. Pulse B. Respirations C. Diaphoresis D. Piloerection E. Blood pressure F. Serum blood glucose result G. Wearing low-top athletic shoes
Sagot :
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