A 16-year-old male client is in the burn unit following a motor vehicle accident. The nurse notes nonpitting edema in the client's left calf. What would the nurse document about this finding?
A) 3+ edema of the left calf
B) Secondary edema of the left calf
C) Nonpitting primary edema of the left calf
D) Primary edema of the left calf
B
Feedback:
Secondary lymphedema develops (1) as a complication of other disorders, such as repeated bouts of phlebitis and streptococcal infection, burns, or insect bites; or (2) as a consequence of treatment, such as the removal of multiple lymph nodes at the time of a mastectomy. Lymphedema following a burn injury is not primary lymphedema as in choice C or D, and it is not pitting edema as in choice A.
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When using mediate or indirect percussion, which technique is appropriate?
a. Place the palmar surface of the nondomi-nant hand on the body surface, with the fingers held together. b. Place the palmar surface of the nondomi-nant hand on the body surface, with the fingers slightly spread apart. c. Place the ulnar surface of the nondomi-nant hand on the body surface, with the fingers together. d. Place the ulnar surface of the nondomi-nant hand on the body surface, with the fingers slightly spread apart.
The nurse has presented an educational session to local politicians about the health impact of discrimination based on sexual orientation. Which statements indicate that further education is needed? (Select all that apply.)
A. "Lesbians who stay at home to raise children receive health care benefits through their partner's employer." B. A lesbian will receive her partner's retirement funds if the partner dies unexpectedly. C. "Lesbian couples can be homeless because of eviction based solely on their sexual orientation." D. "A veteran discharged from the Army because she is lesbian cannot receive care at the Veteran's Administration." E. "A parent with children can be fired in most states if it becomes known that she is a lesbian."
The nurse is caring for a 5-year-old who had surgery yesterday. In order to evaluate the degree of pain the child is experiencing, the nurse will:
a. Expect the child to complain if she is in pain b. Observe for verbal and nonverbal cues that the child is in pain c. Give pain medication if the child is crying d. Ask the child to rate her pain on a scale of 1 to 10
A nurse is reviewing information from the Institute of Medicine (IOM). Which markers of safe and highly reliable care should the nurse find?
A) Team communication B) Formal mentorship C) Proactive decision making D) Innovation