The nurse is caring for a patient 48 hours after mastectomy surgery. The nurse is teaching the nursing student about Core Measures. The nursing student correctly implements which Core Measure intervention(s)? (Select all that apply.)

Question

a. Administering prophylactic antibiotic therapy 48 hours following surgery.
b. Encouraging the older patient to use the call light attached to her when ambulating to the bathroom.
c. Asking the patient to rate her pain on a pain scale.
d. Ensuring that anti-embolic stockings are removed during bathing.
e. Assisting the patient with incentive spi-rometer every 4 hours.

Answer 1

B, D
Core Measures for postsurgical patients, issued by The Joint Commission, address prevention of falls and antithrombosis therapy, which are demonstrated by encouraging use of the call light and anti-embolic stockings that may be removed during skin care. Core Measures state that prophy-lactic antibiotics should be discontinued within 24 hours after surgery. The pain scale and incen-tive spirometer are not Core Measure guidelines. In addition, use of the incentive spirometry should occur more often than every 4 hours.