Then completing nursing care for a client, the nurse should complete an incident report if which of the following situations occurs during care of this client?
a. Blood samples were sent to the lab and results were reported in 4 hours.
b. Diuril 1 g PO was ordered for 1530 and administered at 1600.
c. A visitor stayed 2 hours beyond normal visiting hours.
d. A client who is diabetic and insulin-dependent receives her roommate's regular diet tray.
D
An incident report is a risk management tool used to describe and report any unusual event that occurs to a client, visitor, or employee. It is used by the facility to identify and track problem areas. Documentation should include the time and date, any assessments and interventions made, and time and date the family and physician were notified. The report should then be channeled to the facility's risk management department.
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The nurse is assessing the client's neurologic system. The nurse tests the client's ability to perform stereognosis. Which activity will accurately test this?
1. The nurse places a vibrating tuning fork over the client's ankle and asks the client to indicate when the vibration can no longer be felt. 2. The nurse asks the client to close her eyes and writes the number '7' in the client's palm with the base of the nurse's pen. The nurse asks the client to identify what was written. 3. The nurse asks the client to close her eyes and places a pen in the client's hand. The nurse asks the client to name the object in her hand. 4. The nurse asks the client to close her eyes and indicate where the nurse is touching the client.
While caring for a client with increased intracranial pressure (IICP), a family member asks to assist. Which interventions are appropriate for the nurse to teach the family member regarding this client's care?
Select all that apply. A) The head of the bed should be elevated to 30 degrees. B) The client should remain in a supine position. C) The family should use slow, gentle movements when repositioning the client. D) The client should be repositioned as needed. E) Patients with ICP should remain in a stationary position.
A patient who is being discharged needs to continue taking the zanamivir using a Diskhaler and a bronchodilator. Both the inhaler and the Diskhaler are prescribed at the same time
Which instruction would the nurse include in the teaching plan for the patient? A) Zanamivir should be taken every 6 hours. B) Use the bronchodilator before taking zanamivir. C) Zanamivir used with a bronchodilator causes orthostatic hypotension. D) Risk of disease transmission is minimal during therapy.
Before a patient died, the physician asked the father for permission to use his son's organs, explaining that he is already "brain dead" and the respirator is keeping the other organs alive
The father's response, which is consistent with his Orthodox Jewish faith, would most likely be which of the following? a. "Yes, God would want him to help others." b. "No, his heart is still beating." c. "Yes, his soul is already with God." d. "Yes, but the procedure must be done before sundown."