Question

question: 6 of 19
time remaining: 08:18:15
pause remaining: 00:05:00
pause
a nurse in an emergency department is performing an admission assessment for a client who has severe aspirin toxicity. which of the following findings should the nurse expect?
(select all that apply.)
□ confusion
□ body temperature of 100° f
□ hyperventilation
□ lung crackles
□ respiratory depression
□ seizures
□ bleeding
□ elevated bun

Explanation:

• Confusion: Severe aspirin toxicity affects the central nervous system, causing altered mental status.
• Hyperventilation: Aspirin overdose leads to respiratory alkalosis initially, triggering rapid breathing.
• Seizures: CNS toxicity from high aspirin levels can induce seizures.
• Bleeding: Aspirin inhibits platelet aggregation, increasing bleeding risk.
• Elevated BUN: Renal impairment from toxicity raises blood urea nitrogen (BUN) levels.
• Body temperature of 100°F: Severe toxicity causes hyperthermia (higher than 100°F), so this is not expected.
• Lung crackles: Not a direct finding of aspirin toxicity; related to fluid overload, not the drug's effects.
• Respiratory depression: Occurs in later stages with metabolic acidosis, but hyperventilation is more typical initially in severe cases.

Answer:

Confusion, Hyperventilation, Seizures, Bleeding, Elevated BUN