A client has been admitted to the cardiac intensive care unit following an acute myocardial infarction
The nurse formulates the following nursing diagnosis: Acute pain, related to tissue damage, secondary to infarction, manifested by pallor, client report, and shallow, rapid breathing. Which of the following would be an example of a collaborative intervention?
1. Provide a calm, quiet atmosphere in the client's room.
2. Administer pain medication.
3. Educate the client and family regarding treatment and therapies.
4. Monitor for changes in the client's condition.
Correct Answer: 2
Rationale 1: This option is not collaborative but rathernurse mediated, which the nurse can implement independently.
Rationale 2: Collaboration occurs between the nurse, physician, and other health care professionals to treat the client's problem. In this case, the physician prescribes medications, and the nurse administers them–a primarily dependent action that requires physician orders.
Rationale 3: This option is not collaborative but rather nurse mediated, which the nurse can implement independently.
Rationale 4: This option is not collaborative but rather nurse mediated, which the nurse can implement independently.
You might also like to view...
During a history examination, a patient tells the nurse, "The cardiologist says I have a leaking valve." The nurse documents that the patient has a history of
a. acute mitral regurgitation. c. chronic mitral regurgitation. b. aortic insufficiency. d. pericardial friction rub.
The nurse manager of a medical-surgical unit realized that there are differences in dealing with the varied generations of her nursing staff
How does the nurse manager communicate effectively with the Generation Y staff members (those born after 1980)? a. Typewritten memos b. Staff meetings held monthly for 2 hours c. E-mails or text messages d. Face-to-face interactions
The nurse uses skinfold calipers to:
a. Calculate body mass index. b. Measure the nutritional status of the client. c. Determine the amount of lean body tissue. d. Estimate the amount of body fat.
Helen Strauss, 81 years old, has had a CVA. The rehabilitation staff is very concerned about her insistence on doing everything herself and the resulting safety concerns. This behavior is typical of a
a. Left hemisphere CVA b. Right hemisphere CVA c. Cerebellar CVA d. Brainstem CVA