A nurse discovers that one of your long-term residents has a fungal infection (candidiasis) beneath both breasts. What strategy should the nurse use to prevent spread of this infection?
A. Move the client into a private room.
B. Wash your hands after caring for this client.
C. Wear gloves when providing personal care.
D. Do not allow pregnant staff or visitors into the room.
B
The organism that causes this infection lives on the skin of most adults. Good handwashing is all that is needed to prevent its spread to other people, although the client will need medication to clear her active infection and moisture management to prevent its recurrence.
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When writing a plan of care for a patient with psoriasis, the nurse would know that an appropriate nursing diagnosis for this patient would be what?
A) Impaired skin integrity related to scaly lesions B) Acute pain of the skin and oral cavity related to blistering and erosions C) Risk for injury related to epidermal shedding D) Anxiety and depression related to disfigurement
The nurse is concerned that an older client with dementia is receiving psychotropic medications for sleep. Which assessment findings best indicate the client is experiencing side effects? Select all that apply.
1. Feeling lightheaded upon standing 2. Unable to have bowel movement for four days 3. Hearing a conversation though no one is present 4. Inability to stay awake while completing a puzzle 5. Attempting to swallow one bite multiple times
The nurse working with survivors of a disaster wants to assess them for post-traumatic stress disorder. For which clients does the nurse perform further assessment before administering the Impact of Event Scale–Revised? (Select all that apply.)
a. Older adult survivor with minor injuries b. Woman who lost both her children c. Middle-aged victim with multiple medical problems d. Young adult who had serious orthopedic injuries e. Older adolescent who had a traumatic brain injury
The nurse reports that a client is at risk for a brain attack (stroke) based on which assessment finding?
A. Nuchal rigidity B. Palpable cervical lymph nodes. C. Jugular vein distention D. Carotid bruit