A client has been brought to the emergency department (ED) by a family member. The client is speaking incoherently. To obtain information about the client's current health status, what should the nurse do?
1. Call the client's healthcare provider.
2. Call the Medical Records department to obtain other records for the client.
3. Discuss the situation with the family member who brought the client to the hospital.
4. Conduct a thorough physical assessment and document the health history as "unable to obtain."
Correct Answer: 3
The primary and best source of information for the health assessment interview is the client. In some situations, the client might be unwilling or unable to provide information. The nurse should use another source of information if indicated. This client is incoherent and is accompanied by a family member. The nurse should talk with the family members. Phoning the healthcare provider or calling Medical Records for other admission information might be appropriate at a later time. The nurse should not document the health history as "unable to obtain" since family members are available to provide this information.
You might also like to view...
Which of the following assessment questions would be most appropriate for the role-relationship pattern?
1. "How will this illness affect your job status?" 2. "Do you have any anxiety in your life?" 3. "What can you share with me about yourself?" 4. "What are your hobbies?"
The client is taking steroid medications routinely to control lung disease. In the discharge teaching plan, the nurse includes information on practicing good infection control because steroids cause which of the following?
A) Decrease in the amount of nutrients such as glucose in the blood B) Suppression of the inflammatory process necessary for healing C) Decreased oxygen supply to tissues D) Blood vessel constriction, which impairs waste product removal
A nurse in the emergency department is completing an emergency assessment for a teenager just admitted from a car crash. Which of the following is objective data?
A) "My leg hurts so bad. I can't stand it." B) "Appears anxious and frightened." C) "I am so sick; I am about to throw up." D) "Unable to palpate femoral pulse in left leg."
A/An ____________________ area is one that contains many blood vessels.
Fill in the blank(s) with the appropriate word(s).