Which intervention should the nurse teach the client going home after sinus surgery to prevent bleeding from the surgical site?
A. "Drink at least 8 glasses of water each day."
B. "Sleep in a semisitting position for the first 2 weeks."
C. "Use a stool softener as prescribed to prevent constipation."
D. "Change the mustache dressing whenever it becomes wet or soiled."
C
The client needs to avoid any activity that stimulates the Valsalva reflex and increases pressure within the surgical area. Such activities include bending over, straining to have a bowel move-ment, vomiting, and coughing. Using a stool softener to prevent having to strain will help prevent bleeding from the surgical site.
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The appropriate action for the nurse who is HIV-positive is to:
1. Forfeit her license and stop practicing. 2. Hide her HIV status. 3. Test all patients before and after contact to be sure they are not infected. 4. Avoid exposure-prone procedures.
The target INR range is
a. 1.0 to 2.0 c. 1.5 to 2.5. b. 1.5 to 3.0 d. 2.0 to 3.0.
A nurse is caring for a client with edema due to congestive heart failure (CHF). The primary health care provider has prescribed indapamide. The client is also receiving digoxin. Which intervention would be most appropriate for the nurse to implement?
A) Encourage oral fluids at frequent intervals during waking hours. B) Encourage the client to eat or drink between meals and in the evening. C) Frequently monitor the client's pulse rate and rhythm. D) Closely monitor the client for signs of hyperkalemia.
Outline the extrinsic and intrinsic factors of tissue tolerance that may have had significance for Mrs C during her stay in ICU
What will be an ideal response?