by product of muscle metabolism removal of wastes from the

nurse is reviewing documentation of vital signs by a newly licensed nurse for an assigned client. Which of the following entries in the chart requires follow up by the nurse? BP 130/82 mm Hg left arm, lying. Client reports experiencing postoperative pain as 7 on a scale of 0 to 10. Prescribed analgesic administered and will re-evaluate BP in 30 min. Pulse rate 116/min, left radial, standing, immediately following 10 min of ambulating in hall. SaO2 93% left index finger, client sleeping, nasal O2 dislodged. Nasal O2 readjusted and SaO2 increased to 95%. Respiratory rate 18/min via observation, client sitting in chair.

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