Four hours after applying an external urinary catheter, the nurse observes no urine output in the drainage bag. Which intervention should the nurse implement first?
a. Check the catheter tubing for an obstruc-tion.
b. Ask the patient if he or she feels the urge to void.
c. Notify the provider of inadequate urine output.
d. Increase the patient's fluid intake over the next hour.
B
Ask the patient if he or she senses the urge to void because it may indicate a full bladder. The patient can also have urinary retention with an urge to void but no urine output. If the patient states that he has no urge to void, the nurse can scan the bladder to evaluate its contents. Catheter tubing kinks do not affect the flow of urine with an external urinary catheter in the same way they would if an indwelling catheter were used. There could be some wetting of the perineum with leakage if the catheter tubing is kinked. The nurse would not notify the healthcare provider until performing patient assessment. Increasing the patient's intake can be contraindicated but can be effective to increase urine output.
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Communication has three parts: the sender, the message, and the _____________
ANS:
A client has been prescribed a nasal decongestant for nasal stuffiness due to a common cold. The client is also taking an antidepressant that is a monoamine oxidase inhibitor. The nurse would warn the client about which of the following?
A) Hypotension B) Severe headache C) Sedation D) Bradycardia
A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching?
a. Force fluids to help loosen and liquefy secretions. b. Report clear-colored sputum to the prescriber. c. Avoid driving a car or operating heavy machinery because of the sedating effects. d. Report symptoms that last longer than 2 days.
You are the nurse working on the night shift. You are assigned a middle-aged client who was admitted through the emergency room 4 hours previously. The lab work is not completed or available
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