Nsg process
What should be included in the plan of care for a client with a surgical wound that requires a wet-to-dry dressing?
Cover the wet packing with a dry sterile dressing
After completing the nursing assessment for a client and family entering the palliative care program, the nurse should develop a teaching plan that includes an understanding of what outcome?
-Achievement of a dignified & respectful death -Improvement in the client's quality of life -Provision of comfort during the dying process -Provision of support for client & family
A child with spastic cerebral palsy is to begin Botox injections. What treatment goals should the health care team set for the child r/t Botox?
-Decreased pain for spasticity -Improved motor function -Enhanced self-esteem -Reduced caregiver strain & improved self -are
What assessment has the highest priority & should be accomplished first?
A newly admitted postpartum client who is receiving magnesium sulfate at 3 grams an hour initiated 10 hrs ago for preeclampsia; her infant ate poorly previously and has not eaten for 4 hours.
A client has soft wrist restraints on to prevent removing the NG tune. What nsg intervention should be implemented while the restraints are on the client?
Check on the client q 30 mins while the restraints are on
After talking with the parents of a child with Down syndrome, the nurse should help the parents establish what goal?
Encouraging self-care skills in the child
The nurse is revising a client's plan of care. During what step of the nursing process does she make such revisions?
Evaluation
A hospitalized client fell on the floor & sustained a small laceration on the hand that required stitches. The intern will suture the client's hand at the client's bedside and asks for bupivacaine (Marcaine) with epinephrine and a suture kit in order to suture the laceration. The nurse should question what?
Marcaine with epinephrine as the local anesthetic
The nurse is caring for a client who states, "I am really worried about how I'm going to pay my hospital bill." The first action of the nurse should be to:
Sit with the client and allow the client to verbalize concerns
An A&O elderly client is admitted to the hospital for treatment of cellulitis of the left shoulder after an arthroscopy. What fall prevention strategy is most appropriate for this client?
Use a nightlight in the bathroom
A client is complaining about blurred visit after 4 days of taking haloperidol (Haldol) 1mg BID, and benztropine (Cogentin) 2mg BID. The nurse contacts the primary health care provider to explain the SBAR. What info reported to eht primary health care provider is the assessment of the situations?
"The Higher dose of Cogentin could be causing Mr. Robert's blurred visino.
When planning care for a client with ulcerative colitis who is experiencing an exacerbation of symptoms, what client care activities can the nurse appropriate delegate to an unlicensed assistant?
-Proving skin care following BMs -Maintaining I&O records -Obtaining the client's weight
A charge nurse on hematology/oncology unit is reviewing the policy for using abbreviations with the staff. The charge nurse should emphasize what about why dangerous abbreviations need to be eliminated?
-To ensure efficient & accurate communication -To prevent medication errors -To ensure client safety
The client has a latex allergy. What should the nurse teach the client to do before having surgery at a free-standing surgery center?
-Determine that there will be a latex-safe environment for surgery -Report symptoms experienced with the latex allergy (e.g., rhinitis, conjunctivitis, flushing) -Notify the health care providers at the surgery center
