When assessing a patient who has cirrhosis, which finding would best indicate the patient is developing ascites?
1. Accumulation of fluid in the abdomen
2. Yellow skin
3. Ecchymosis
4. Upper-right-quadrant pain
1
Rationale 1: Ascites is the accumulation of the fluid in the abdomen and is a result of portal hypertension.
Rationale 2: Yellow skin is a manifestation of jaundice and is associated with hepatic disorders.
Rationale 3: The patient experiencing hepatic problems might have bleeding and bruising issues due to inadequate vitamin K.
Rationale 4: Obstructed biliary flow could be the cause of upper-right-quadrant pain.
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The postpartum client reports pain rated 4-5 and requests medication. The baby is crying and the mother thinks the baby is hungry. The nurse will:
1. Put the baby to breast while the nurse gets the client an analgesic. 2. Put the baby to breast and wait until after breastfeeding is completed for analgesia. 3. Administer the analgesic and give the baby a bottle so the mother doesn't have to breastfeed. 4. Give the analgesic immediately and then put the baby to breast.
The nurse is to administer 1 mL of prochlorperazine (Compazine) 10 mg IM to an adult patient. Which syringe will the nurse select to administer the medication?
a. 1 mL tuberculin syringe with 27 gauge, inch needle b. 3 mL syringe with 23 gauge, inch needle c. 1 mL syringe with 27 gauge, inch needle d. 3 mL syringe with 18 gauge, 1 inch needle
A patient has been admitted to the emergency department after experiencing a chemical burn to the eye in an workplace accident. Which of the following interventions will be included in this patient's plan of care? Select all that apply
A) Eye irrigation until eye pH normalizes B) Eye range-of-motion exercises to preserve function C) Manual cleansing of the cornea with sterile gauze D) Instillation of antibiotics E) Application of an eye patch following immediate treatment
You are preparing to discharge home a patient who is status post thoracotomy. The patient is going home on oxygen therapy and will be followed at home by a home care nurse
What would be important for you to include in your discharge teaching for this patient? A) Correct breathing techniques B) How to do postural drainage C) Correct and safe use of oxygen therapy equipment D) How to provide safe and effective tracheostomy care