The nurse notices that the patient's stoma is darker than before, purplish in color, and dry. The patient has been taking care of the ostomy independently. What action should the nurse take in-itially?
a. Document the findings.
b. Ask how the patient is measuring the sto-ma.
c. Call the healthcare provider.
d. Rub the stoma to see if it bleeds.
B
The first action is to find out from the patient the technique used for determining the size of the opening for the stoma. If it is too tight, the blood supply to the stoma could be decreased. Infor-mation needs to be obtained before documenting or notifying anyone else. Rubbing the stoma may cause injury. Since the stoma should be highly vascular, slight bleeding might be seen when it is cleaned.
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The intraoperative nurse is implementing a care plan that addresses the surgical patient's risk for vomiting. Interventions that address the potential for vomiting reduce the risk of what subsequent surgical complication?
A) Impaired skin integrity B) Hypoxia C) Malignant hyperthermia D) Hypothermia
A patient comes to the clinic for a follow-up appointment after being released from the hospital for angina. The nurse is discussing his medication, nitroglycerin
The nurse is correct to state that the principal way this medication relieves the pain of stable angina is by a. strengthening blood pressure. b. reducing cardiac oxygen demand. c. promoting vagal stimulation. d. increasing sympathetic stimulation to the heart.
The nurse is observing a UAP assist a client with a vascular problem back into bed. The nurse would intervene if the UAP placed this client in what position in the bed?
A. Low-Fowler B. Semi-Fowler C. Orthopneic position D. Elevate knee-gatch position
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