A client is expressing great disappointment that the plastic surgery did not turn out as well as expected. The client is distressed over visible scarring and lingering edema. The most appropriate nursing diagnosis for this client is
a. Altered Coping
b. Disturbed Body Image
c. Fear
d. Situational Low Self Esteem
B
The most appropriate diagnosis is Disturbed Body Image since the client is complaining about the way his/her body looks postoperatively. If the client made negative comments about him/herself, the diagnosis would be Situational Low Self-Esteem. The client made no comments that would lead the nurse to choose either of the other two options.
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An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. The nurse's health education should include which of the following?
A) Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker B) Maintaining a diet high in dairy to increase protein necessary to prevent organ damage C) Use of strategies to prevent falls stemming from postural hypotension D) Limiting exercise to avoid injury that can be caused by increased intracranial pressure
The nurse is anticipating the arrival of a pediatric client with Mycobacterium scrofulaceum. The nurse anticipates the child will be between the ages of 1 and _______ years
Standard Text: Record your answer rounding to the nearest whole number. Fill in the blank with the appropriate word.
To prevent injury to a pt during logrolling, which action by the nurse is most important?
a. Place an ankle foot orthotic on the pt prior to movement b. Remove the pt's drawsheet to avoid lower extremity entanglement c. Position a pillow between the pt's legs to maintain body alignment d. Raise all four side rails prior to initiating logrolling independently
Which assessment finding would cause the nurse to question whether a preschool-age boy, diagnosed with phenylketonuria shortly after birth, is following the prescribed dietary restrictions?
1. The child's body has a musty odor. 2. This child is a blue-eyed blond. 3. The child appears sleepy and uninterested in the surroundings. 4. The child has a sunburn over his entire body.