The nurse prepares to exercise a digital removal of feces. To detect an untoward effect of this procedure, the nurse should assess the patient history for which condition?
a. Heart disease
b. Abdominal pain
c. Urinary infection
d. Diabetes mellitus
A
Because of the potential to stimulate the vagus nerve, patients with a history of dysrhythmia or heart disease are at greater risk for changes in heart rhythm. Be sure to monitor the patient's pulse before and during the procedure. This procedure may be contraindicated in cardiac patients; if in doubt, verify with the physician. Symptoms of fecal impaction include constipation, rectal discomfort, anorexia, nausea, vomiting, abdominal pain, diarrhea (around the impacted stool), and urinary frequency. Abdominal pain by itself is not indicative of the need for extra caution. Symptoms of fecal impaction include urinary frequency, not infection. There is no correlation between the two.
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The nurse palpates a downward small protrusion of the helix known as Darwin's tubercle. The nurse should document this as which of these?
a. An abnormal palpable calcification b. Within normal limits c. A lump filled with fluid d. A tumor
When you apply sharp and dull stimuli to assess your patient' sensation of superficial pain, the patient reports impaired sensation on the lower left leg
You attempt to define the area of diminished sensation by applying stimuli to that extremity from the a. area of normal sensation to the area of impaired sensation. b. groin toward his foot. c. knee toward his foot. d. area of impaired sensation to the normal area.
A client has been diagnosed with a rare autosomal recessive disorder. Which finding is the nurse most likely to assess in the client's pedigree?
1. Deaths from other autosomal recessive disorders 2. Many families units with only one child 3. Marriages between first cousins 4. An unusual number of adopted children
The incidence of rebleeding after a ruptured cerebral aneurysm is highest during which of the following time periods?
a. First 24 hours b. 4 to 12 days c. 3 to 4 weeks d. 3 to 6 months