The nurse reviews the care plan for a patient with cancer of the liver and learns the plan of care focuses on palliative measures. Noting that over the last 3 weeks the patient's condition has continued to deteriorate, the nurse recognizes that:
A) Death will occur in the next week.
B) The patient is in the trajectory phase of chronic illness.
C) The patient is in the downward phase of chronic illness and should be reassessed.
D) The patient should immediately be admitted into the hospital.
Ans: C
Feedback: The downward phase occurs when symptoms of chronic illness worsen despite attempts to control the course through proper regimen management. A downward turn does not necessarily lead to death. A downward trend can be arrested and the trajectory reestablished at any point depending on the condition and the treatment. A patient who is palliative may not desire hospitalization and aggressive treatment.
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1. "Protein is important; therefore, the addition of one serving of meat a day is necessary." 2. "A daily supplement of 4 mg vitamin B12 is important." 3. "The high fiber in a vegetarian diet is dangerous for pregnant women." 4. "Eggs are important to add to your diet. Eat six eggs per week." 5. "Milk products contain protein, but they are very low in iron."
A patient is on an anticoagulant. The patient also occasionally takes goldenseal for cold symptoms. What should the nurse teach the patient about the use of herbal drugs and anticoagulant therapy?
a. Herbal drugs may decrease clotting times. b. Herbal drugs may increase the risk of bleeding. c. There are no risks associated with this drug combination. d. They are safe to take together if you take them an hour apart.
Which type of documentation makes the strongest use of flow sheets?
1. PIE charting 2. Focus charting 3. CORE charting 4. Source-oriented narrative record
A nurse is working with a client who has demonstrated low situational self-esteem related to a new diagnosis of cancer. What would be an appropriate goal for this client?
a. The client will admit the need for help at home. b. The client will state two positive aspects of his life. c. The client will decide to quit work during treatment. d. The client will not demonstrate anxiety or fear.