The nurse assists the client with emphysema admitted because of a respiratory infection to assume what position to reduce the effort of breathing and improve gas exchange?
1. Left Sims' position
2. Fowler's position
3. High Fowler's position
4. Orthopneic position
4
Rationale: This client, also with increased work of breathing, should be placed in the orthopneic position because it allows for the greatest chest expansion and makes breathing easier. The client is placed at a 90-degree angle leaning on an over-bed table to achieve this position. The second best position would be the high Fowler's or Fowler's position, but it is not as effective as the orthopneic position, because the pressure on the back reduces chest expansion. Sims' position is side-lying, and would likely increase the client's respiratory distress, as chest expansion would be reduced on the side she is lying on.
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The priority intervention to improve work-related quality of life for nurses is to:
a. provide safe harbors for unjust or unsafe work assignments. b. improve nurse physician communications. c. require professional development courses for bedside nurses. d. determine strategies to improve vertical working relationships between staff nurses and nursing administration.
A nurse believes a new mouth care procedure (MCP) is causing more mouth problems than it is helping to avoid. Which of the following must be present for the nurse to go to administration
with confidence that the new mouth care procedure (MCP) is causing problems? (Select all that apply.) a. A plausible explanation of how the new MCP could cause harm b. A strong feeling that the MCP is the cause c. Consistently seeing mouth inflammation in many of the patients who have received the MCP d. Documentation from patient records that mouth inflammation in clients did not occur until after the new procedure was implemented
What instructions should the nurse relate to Mr. H?
A. Do no try to void around the catheter B. Drink more fluid to relieve pressure C. Start pelvic floor muscle exercises D. Ask for your pain medication sooner
The client had a liver transplant and asks the nurse if she really needs all of those medications. How should the nurse respond?"
1. "Yes, this is necessary for you to not reject the new liver, but in time you will be down to only one medication." 2. "Yes you need these medications so you won't reject your new liver, but with current cloning techniques in about 5 years you should be able to grow enough new liver cells to support your life." 3. "You need these medications because it is important to dampen your immune response so you won't reject your new liver." 4. "New research indicates that immunosuppressant drugs are only needed for 6 months after transplant."