The client complains of blurred vision after taking the eye drops. What does the nurse implement first?
1. Withholds the client's ophthalmic drops
2. Warms the eye drops for subsequent doses
3. Notifies the ophthalmologist of the findings
4. Asks the client questions to clarify "blurred"
4
4. The nurse questions the client for additional information before determining the scope of the client's complaint because blurred vision can be an adverse effect of the medication that the client needs to manage.
1. The nurse gathers additional information before deciding to withhold the eye drops.
2. The nurse avoids warming eye drops because it can increase the absorption rate and client discomfort.
3. Notifying the provider is not indicated.
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A nurse is assessing a patient's stoma on postoperative day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding?
A) Irrigate the ostomy to clear a possible obstruction. B) Contact the primary care provider to report this finding. C) Document that the stoma appears healthy and well perfused. D) Document a nursing diagnosis of Impaired Skin Integrity.
Adequate fluid intake is essential to wound healing. If not contraindicated, the nurse should encourage the client to drink at least:
A) 600 mL daily. B) 1200 mL daily. C) 1800 mL daily. D) 2500 mL daily.
On the fourth day postpartum, a woman develops breast engorgement. Which of the following measures would be best to recommend to her as a means of alleviating this problem?
A) Discontinuing breastfeeding for 24 hours B) Decreasing her fluid intake to below 500 mL per 24 hours C) Encouraging her to continue regular breastfeeding D) Having her apply lanolin cream to each breast
The nurse is caring for a patient with Ménière disease. Which action is most important for the nurse to take?
a. Speak loudly and clearly into the affected ear. b. Restrict sodium intake. c. Encourage frequent ambulation. d. Encourage fluid intake.