The nurse is caring for an older adolescent client diagnosed with malignant melanoma. Which nursing diagnoses would be appropriate when planning this client's care?
Select all that apply.
A) Impaired Skin Integrity
B) Risk for Compromised Human Dignity
C) Anxiety
D) Risk for Acute Confusion
E) Disturbed Body Image
Answer: A, C, E
Any client will likely experience anxiety and impaired skin integrity related to the diagnosis of skin cancer. The client will not likely have compromised human dignity or a risk for acute confusion. Disturbed body image could be an issue if the lesion is large.
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The nurse works in an oncology clinic. A preschool-age child is being seen in the clinic, and the nurse anticipates a diagnosis of cancer
The nurse prepares for which of the common reactions preschool-age children have following illnesses and hospitalizations? 1. Unawareness of the illness and its severity 2. Acceptance, especially if able to discuss the disease with children their own age 3. Understanding of what cancer is and how it is treated 4. Thoughts that they caused their illness and are being punished
The patient has been diagnosed as having gouty arthritis. He asks the nurse to explain the cause of the inflammation of his great toe. The most appropriate nursing response is
a. "You have calcium oxalate deposits that are seen in gouty arthritis." b. "The inflammation is from small accumulations of uric acid crystals which are called tophi." c. "The small nodules are not related to the arthritis condition." d. "You have fat deposits that are common with gouty arthritis."
A nurse is obtaining a health history from a patient. The nurse suspects a drug-drug interaction and instructs the patient to list every medication he is taking
Which statement would indicate that the patient needs further teaching regarding inclusion of medication history? a. The patient would be correct to include prescription medications. b. The patient would be correct to include vitamins and over-the-counter medica-tions. c. The patient would be correct to omit listing his daily use of herbal teas. d. The patient would be correct to omit listing occasional (once a week) use of al-cohol.
Hostile or angry patients present unique nursing challenges from a legal perspective. Which option reflects a basic intervention that a nurse can take with a hostile or angry patient?
1. Allow the patient to be alone and have long periods of quiet time. 2. Ensure that family members are always present to calm the patient. 3. Spend additional time with the patient, showing that he or she is important. 4. Sedate the patient to diffuse further encounters with the patient.