The nurse would realize that additional teaching is needed when the client with a ureteroileosto-my says "I
a. am going shopping for new clothing that will better accommodate the pouch."
b. will change the pouch when it begins to leak."
c. won't drink too much so the amount of urine I make will be less."
d. am going to cut down on eating dairy products."
C
The client with a ureteroileostomy should maintain a daily fluid intake of at least 3 L (3 quarts) unless there is another reason why the client should not have this amount of fluid. These clients are at high risk of developing kidney stones and pyelonephritis, and maintaining a high intake and normal urine output will help prevent these complications.
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The nurse is assessing a client and notes a loud, blowing sound over the right carotid artery. Based on this data, which diagnosis does the nurse anticipate?
1. Mitral stenosis. 2. Aortic regurgitation. 3. Atrial septal defect. 4. Stricture of the carotid.
The nurse delegates the unlicensed nursing assistant (UAP) to ambulate an older adult client. What information must the nurse communicate to the UAP when delegating this task?
a. "The client has skid-proof socks, so there is no need to use your gait belt." b. "Teach the client how to use her walker while you are ambulating up the hall." c. "Sit the client on the edge of the bed with legs dangling before ambulating." d. "Ask the client if she needs pain medica-tion before you walk her in the hall."
An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for:
a. decreased effectiveness of the drug. b. shorter period of the drug's effects. c. signs of drug toxicity. d. unusual CNS effects.
The nurse is determining how a patient is going to respond to prescribed medical treatment for an illness. What factors will influence the patient's response? Select all that apply
1. Religion 2. Ethnicity 3. Culture 4. Family structure