Questions: The new grad nurse on orientation admits a 79-year-old man to the hospital with shortness of breath. The preceptor performs a brief bedside assessment after the new grad. Which assessments should the preceptor perform? Select all that apply. - Observing general appearance - Observing environment - Auscultation of bowel sounds - Auscultation of the heart sounds - Auscultation of the breath sounds - Asking the client about last bowel movement - Reviewing the vital signs - Observing the client's gait when ambulating - Observing the breathing pattern

The question asks which assessments the preceptor should perform for a 79-year-old man admitted with shortness of breath. The patient has a history of COPD, coronary artery disease, peripheral vascular disease, and hypertension. The new grad nurse has already performed an initial assessment, and the preceptor is to follow up with additional assessments.

The answer is:

• Observing general appearance
• Auscultation of the heart sounds
• Auscultation of the breath sounds
• Reviewing the vital signs
• Observing the breathing pattern

Explanation for each option:

1. Observing general appearance: Correct. This helps in assessing the overall condition of the patient, including signs of distress, fatigue, or other visible symptoms.

2. Observing environment: Incorrect. While important for safety and comfort, it is not a direct assessment of the patient's current health status.

3. Auscultation of bowel sounds: Incorrect. The patient's primary issue is respiratory, not gastrointestinal, and bowel sounds were already noted as normal.

4. Auscultation of the heart sounds: Correct. Given the patient's history of coronary artery disease, assessing heart sounds is crucial to identify any abnormalities.

5. Auscultation of the breath sounds: Correct. This is essential for evaluating the extent of the patient's respiratory distress and the presence of crackles or other abnormal sounds.

6. Asking the client about last bowel movement: Incorrect. This is not immediately relevant to the patient's respiratory condition.

7. Reviewing the vital signs: Correct. Vital signs provide critical information about the patient's current status and any changes since the initial assessment.

8. Observing the client's gait when ambulating: Incorrect. While this can be important, it is not immediately relevant to the patient's respiratory distress.

9. Observing the breathing pattern: Correct. This helps in assessing the severity of the patient's dyspnea and the effectiveness of their breathing.

Summary: The preceptor should focus on observing the general appearance, auscultating heart and breath sounds, reviewing vital signs, and observing the breathing pattern to comprehensively assess the patient's respiratory and cardiovascular status.