A patient with HIV has a nursing diagnosis of Risk for Impaired Skin Integrity. What nursing intervention best addresses this risk?
A) Utilize a pressure-reducing mattress.
B) Limit the patient's physical activity.
C) Apply antibiotic ointment to dependent skin surfaces.
D) Avoid contact with synthetic fabrics.
Ans: A
Feedback:
Devices such as alternating-pressure mattresses and low-air-loss beds are used to prevent skin breakdown. Activity should be promoted, not limited, and contact with synthetic fabrics does not necessary threaten skin integrity. Antibiotic ointments are not normally used unless there is a break in the skin surface.
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A patient, age 39, receiving chemotherapy for treatment of her cancer has a white blood cell count of 1600/mm3. This finding requires nursing interventions to provide which of the following?
a. Adequate fluid intake b. Protection from falls c. Protection against infection d. Frequent small nutritious snacks
The role of glucocorticoids in the hypothalamic-pituitary-adrenal (HPA) axis is to serve as which of the following?
a. To activate T lymphocytes in the immune system b. To diminish phagocytosis in the inflammatory process c. To prevent further release of the corticotrophin releasing factor (CRF) d. To stimulate the further release of serotonin and norepinephrine
As a part of a malpractice case, the hospital has decided to bring an indemnity claim against a nurse. What is the implication to the nurse?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The nurse should obtain a private lawyer. 2. The nurse will have to pay monetary damages to the hospital if the hospital wins the claim. 3. The nurse is required to disclose patient information that the patient believed would be kept confidential between the nurse and the patient. 4. The hospital is released from paying monetary damages to the nurse. 5. The hospital attorney has identified the work practices implicated in the incident causing the lawsuit.
A patient who has been taking a benzodiazepine for panic attacks is to be started on buspirone (BuSpar). Which instruction should the nurse provide?
a. "Take decreasing doses of the benzodiazepine for several days until the buspirone becomes effective." b. "Stop taking the benzodiazepines immediately. Wait 2 days, and then start the buspirone." c. "You should take buspirone only once a day. More frequent dosing can cause dependency." d. "Tolerance to buspirone may develop in about a month, requiring larger doses to be prescribed."