Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy?
a. Notify the doctor about bloody nasogastric (NG) drainage.
b. Elevate the head of the bed to at least 30 degrees.
c. Reposition the NG tube if drainage stops.
d. Start oral fluids when the patient has active bowel sounds.
b. Elevate the head of the bed to at least 30 degrees.
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The outcome that should be established for an elderly patient with delirium caused by fever and dehydration is that the patient will:
a. return to a premorbid level of functioning. b. demonstrate motor responses to noxious stimuli. c. identify stressors negatively affecting self. d. exert control over responses to perceptual distortions.
A nurse has reported for a shift at a busy burns and plastics unit in a large university hospital. Which patient is most likely to have life-threatening complications?
A) A 4-year-old scald victim burned over 24% of the body B) A 27-year-old male burned over 36% of his body in a car accident C) A 39-year-old female patient burned over 18% of her body D) A 60-year-old male burned over 16% of his body in a brush fire
An 88-year-old, being admitted to rule out lung cancer, is assessed using the short form of the Geriatric Depression Scale tool. When it is determines that the earned score is 9, the nurse initially:
a. asks if they have any thoughts of committing suicide b. recognizes that this score is not indicative of depression c. knows it is not unusual for clients this age to earn such a score d. notifies the client's healthcare provider immediately
A client tells the nurse that he continues to relive a situation in which his place of employment was robbed by gunmen and he has nightmares of being shot
The nurse would identify the most appropriate nursing diagnosis for this client as being: 1. Anxiety. 2. Ineffective Coping. 3. Post-traumatic Stress Disorder. 4. Fear.