The nurse is assessing a client's right lower extremity and during inspection notes an area of redness. In order to assess the temperature of the client's skin, the nurse should use which part of the hand?

1. Fingertips
2. Metacarpophalgeal joints
3. Dorsal surface
4. Ulnar surface


3
Rationale 1: The fingertips are used for identifying underlying skin structures and functions such as pulses, superficial lymph nodes, or crepitus.
Rationale 2: The metacarpophalgeal joint area of the hand is used to assess for vibration, or fremitus.
Rationale 3: The skin on the dorsal surface of the fingers and the hand is thinner; therefore, it is the best area to assess skin temperature.
Rationale 4: The ulnar surface of the hand is also used to assess for fremitus.

Nursing

You might also like to view...

The LPN/LVN makes nursing decisions based on critical thinking and

1. Scientific data 2. Opinions 3. Judgements 4. Assumptions 5.

Nursing

The home health nurse is informed by her patient that she is taking a herbal over-the-counter medication. What action should the nurse take with this information?

A. This information is not part of the medication record. B. The nurse should document this information and add it to the patient's medication list and notify the charge nurse of the change. C. Research the benefits of this medication before deciding if it should be added to medication record. D. Tell the patient that herbal medications are not considered safe to take.

Nursing

Which of the following arteries provides blood supply to the breast?

a. Retromammary and external mammary b. Lateral thoracic and internal mammary c. Medial thoracic and internal mammary d. Lateral thoracic and external mammary

Nursing

A client has a continuous bladder irrigation running after prostatectomy. During the shift, 600mL of one bag of irrigant is infused and 1500mL of the next bag has also infused

Upon draining the urine bag three times during the shift, the nurse measures the volumes emptied to be 800mL, 1,050mL, and 950mL. The nurse expects the volume out to be greater than the volume in and calculates the excess fluid to be which of the following? 1. 950mL 2. 1000mL 3. 700mL 4. 250mL

Nursing