The nurse is educating a patient about care of a stoma after discharge. Which of the following statements indicate a good level of understanding? (Select all that apply.)
a. "I should apply gentle pressure with my hand over the skin barrier to facilitate ad-herence.".
b. "I should also use a skin prep such as a paste or adhesive first.".
c. "I can get a pouch that absorbs gas odors.".
d. "I need to change the pouch every 3 to 7 days.".
A, C, D
The current trend is to apply a pouch to clean, dry skin without other skin preparations, paste, or adhesives unless a patient has a specific problem keeping a pouch intact. The adhesives on the skin barriers are pressure and heat sensitive; thus have the patient apply gentle pressure with the hand over the skin barrier for several minutes to facilitate the adherence of the barrier to the skin. Some pouches have effective gas filters that absorb odors and allow for flatus to escape slowly from the pouch through a charcoal filter. Pouches should be changed every 3 to 7 days.
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A man with a neurogenic bladder secondary to a spinal tumor has been taking bethanechol. The patient has illuminated his call light, and the nurse has found him anxious, diaphoretic, and visibly flushed
Following a safety assessment, what action should the nurse take? A) Prepare to administer an IV dose of epinephrine to mitigate the effects of acetylcholine. B) Contact the physician as the patient may be experiencing a cholinergic crisis. C) Insert a Foley catheter as the patient may have excessive urine in his bladder. D) Assess the volume of the patient's bladder contents using a bladder ultrasound.
The ethical tenets that underlie the core function of assessment are (select all that apply)
a. Competency: the persons assigned to develop community knowledge are prepared to collect data on groups and populations b. Moral character: the persons selected to develop, assess, and disseminate community knowledge possess integrity c. Service to others over self: a necessary condition of what is "good" or "right" policy d. "Do no harm": disseminating appropriate information about groups and populations is morally necessary and sufficient
Which drug stimulates the liver to break down glycogen?
a. Bilirubin b. Glucagon c. Insulin d. Levothyroxine
The nurse is administering a cleansing enema. Which action would indicate the need for further instruction on the process?
1. Enema solution is warmed to 40°C (105°F). 2. The solution container is held 12 inches above the rectum. 3. The client is in the Fowler's position. 4. The client is encouraged to retain the enema for 5–10 minutes.