A patient who has been on antibiotic therapy for 3 weeks has a cottage cheese–like coating on the teeth, gums, and roof of the mouth. What is the nurse's best action?
a. Take a specimen and send it to the laboratory for culture.
b. Hold the dose and notify the prescriber immediately.
c. Document this expected finding as the only response.
d. Assist the patient to perform frequent mouth care.
D
Prolonged antibacterial therapy can cause an oral yeast infection (thrush) by killing off the normal flora of the mouth. This infection causes a white, cottage cheese–like coating on the gums, roof of the mouth, or insides of the cheeks, which is not an allergic reaction nor is it a reason to stop the drug therapy. Help the patient use good oral hygiene with tooth-brushing and mouthwash at least every shift.
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The nurse can best avoid catheter occlusion in a client with a recently inserted venous access device (VAD) by
a. administering medications in small volumes. b. flushing the catheter per agency protocol. c. instructing the client to keep the arm extended during administration. d. using the catheter only for vesicant drugs.
The client has been placed on a 1200mL oral fluid restriction. How should the nurse plan for this restriction?
A) Instruct the client that the 1200 mL of fluid placed in the bedside pitcher must last until tomorrow. B) Remove fluids from diet trays and offer them only between meals. C) Allow 600 mL from 7 to 3, 400 mL from 3 to 11, and 200 mL from 11 to 7. D) Offer the client softer, cold foods such as sherbet and custard.
An aggressive client removes herself from an environment on the unit that is overstimulating. One beneficial approach for the nurse to use with this situation is:
A) Validation. B) Information. C) Reward. D) Commendation.
A nurse administers an intelligence quotient (IQ) test for an 11-year-old child with
complaints of decreased memory and difficulty concentrating. What is the significance of standard IQ tests? A) IQ tests are used to determine success in life. B) IQ tests indicate different types of intelligence. C) IQ tests are good predictors of work productivity. D) IQ tests are good predictors of academic achievement.