The patient applies sequential compression devices after going to the bathroom. The nurse checks the patient's application of the devices and finds that they have been put on upside down
Which of the following nursing diagnoses will the nurse add to the patient's plan of care?
a. Risk for poisoning
b. Deficient knowledge
c. Risk for imbalanced body temperature
d. Risk for suffocation
ANS: B
The patient needs to understand the purpose of the compression devices and that proper application is needed for them to be effective. The patient has a knowledge need and requires instruction regarding the device and its purpose and procedure. The nurse will intervene by teaching the patient about the sequential compression device and instructing the patient to call for assistance when getting up to go to the bathroom in the future, so that the nurse may assist with removal and proper reapplication. No data support a risk for poisoning, imbalanced body temperature, or suffocation.
You might also like to view...
An ICU nurse manager is having concerns regarding summer scheduling. The manager discusses concerns during a nursing administration meeting. The CNO (chief nurse officer) asks the nursing management what solutions they have to address this issue
Which of the following would be most beneficial to nursing staff and nursing management? 1. Rotating shifts 2. Innovative work schedules 3. Fixed shifts 4. Job sharing
The nurse is working in an outpatient studies unit administering neurologic tests. The client is surprised that paste is used to secure an electroencephalogram and asks how it will be removed from the hair. The nurse is most correct to state which?
A) The paste is removed with acetone. B) The paste is removed with a special soap. C) The paste is removed with standard shampoo. D) The paste is removed by flushing with warm water.
The nurse is planning care for a preterm infant. What should the nurse identify as goals for this infant's care? (Select all that apply.)
A) Accelerate growth B) Monitor fluid balance C) Preserve skin integrity D) Protect neurologic status E) Improve respiratory function
MC A group of middle-age women ask the nurse to prepare a presentation on the relationship of menopause and depression. The nurse researches the topic and includes the following information in the presentation
A. Menopause is a risk for major depression. B. Progression through natural menopause is not a risk for major depression. C. Depression prior to menopause actually delays menopause. D. Postpartum depression leads to a lower risk for depression during perimenopause.