The priority nursing diagnosis for a patient experiencing an acute attack with Meniere's disease is
a. risk for falls related to dizziness.
b. impaired verbal communication related to tinnitus.
c. self-care deficit (bathing and dressing) related to vertigo.
d. imbalanced nutrition: less than body requirements related to nausea.
ANS: A
All the nursing diagnoses are appropriate, but because sudden attacks of vertigo can lead to "drop attacks," the major focus of nursing care is to prevent injuries associated with dizziness.
You might also like to view...
A patient develops toxic acute tubular necrosis (ATN) as a result of exposure to a radiocontrast dye. Which of the following should the nurse most expect to observe in this patient as this condition progresses beyond the onset phase?
A) Normal potassium levels B) Duration of 7 to 14 days C) Normal urine concentrating function D) Normal urine volume
Which of the following is an example of cultural humility?
1. A nurse familiarizes herself with the requirements of kosher food. 2. A nurse believes that giving Jell-O to all patients after surgery has no cultural implications. 3. Patients and family members are discouraged from praying on the floor to protect their hygiene and safety. 4. All of the above.
A male patient reports decreased libido and the nurse notes galactorrhea during a physical assessment. The nurse will report these findings to the provider and will anticipate an order for which medication?
a. Cabergoline b. Conivaptan c. Dopamine d. Prolactin
A nurse is caring for a 12-year-old client who has had multiple seizure attacks since she was 5 years of age. Which of the following measures should the nurse employ when the client is having a seizure?
A) Put something in the mouth to keep it open. B) Observe for a flushing of the skin. C) Elevate the head of the bed to 45 degrees. D) Place a soft pad beneath the client's head.