The patient database reveals that a patient has decreased oral intake, decreased oxygen saturation when ambulating, reports of shortness of breath when getting out of bed, and a productive cough
Which elements will the nurse identify as defining characteristics for the diagnostic label of Activity intolerance?
a. Decreased oral intake and decreased oxygen saturation when ambulating
b. Decreased oxygen saturation when ambulating and reports of shortness of breath when getting out of bed
c. Reports of shortness of breath when getting out of bed and a productive cough
d. Productive cough and decreased oral intake
ANS: B
There are defining characteristics (observable assessment cues such as patient behavior, physical signs) that support each problem-focused diagnostic judgment. The signs and symptoms, or defining characteristics, for the diagnosis Activity intolerance include decreased oxygen saturation when ambulating and reports of shortness of breath when getting out of bed. The key to supporting the diagnosis of Activity intolerance is that only these two characteristics involve how the patient tolerates activity. Decreased oral intake and productive cough do not define activity intolerance.
You might also like to view...
During PTCA, a patient who received a coronary artery stent is informed that she will need to take aspirin for the rest of her life. The nurse informs her that aspirin is prescribed to prevent:
A) Thrombus formation B) Dysrhythmias C) The onset of pain D) Hemorrhage at the stent site
A nurse is working in a community setting caring for persons with mental health problems and their families. Which of the following is the most important and critical task for this nurse?
a. Be an advocate by writing letters to legislators demanding more resources for care for the mentally ill b. Encourage all those involved to fight the community's tendency to stigmatize the mentally ill and their families c. Establish supportive interpersonal relationships with all those involved d. Lobby for increased funding for care of the mentally ill
Credibility in qualitative research refers to which of the following?
A) The reliability of data over time B) Objectivity of the interpretation of the data C) Applicability of the data to other groups D) Confidence in the truth value of the data
A nurse is assessing a young man who is being treated for sterility and inquires whether the young man had any common childhood disease that may be the cause of sterility. What child-hood disease might result in sterility?
a. Mumps b. Chicken pox c. Measles d. Scarlet fever