In the postanesthesia care unit, the nurse applies an ice bag to the client's cast at the surgical site. Which therapeutic effect does the nurse expect from this treatment? (Select all that apply.)
1. Analgesia
2. Hemostasis
3. Diaphoresis
4. Oxygenation
5. Inflammation
6. Vasoconstriction
1, 2, 6
1, 2, and 6. The nurse applies cold therapy to the client's surgical site for regional vasoconstriction and analgesia. Exposure to cold stimulates the body to shunt blood to vital organs; thus, peripheral vessels vasoconstrict to decrease the available volume in exposed tissue for warm blood. Vasoconstriction not only sustains the function of vital organs but also decreases blood flow to limit edema, inflammation, and bleeding. These are highly desirable therapeutic effects after orthopedic surgery with a cast application because edema, inflammation, and bleeding increase fluid in the region and potentially increase the pressure within the cast, compress tissue, and in-crease the client's risk of impaired perfusion to the region. Cold therapy provides analgesia by limiting the pressure from fluid and blood accumulation and by an anesthetic response.
3. Diaphoresis commonly occurs with dry heat therapy.
4. Cold therapy vasoconstricts, so oxygenated blood flow does not increase; however, the nurse withdraws cold therapy before tissue damage occurs.
5. Inflammation is not a therapeutic effect of cold therapy and is usually an undesira-ble outcome.
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Which principle of ethics does the nurse use when refusing to work a 12-hour shift for six
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