A client is on hospice with a diagnosis of end-stage heart failure. The family wants to know what the goals of treatment will be. The hospice nurse relates to them that the primary goal of treatment is tp:
1. Provide comfort and reduce any distressing respiratory symptoms.
2. Provide significant pain medications.
3. Keep the client out of the hospital.
4. Provide information to the family.
To provide comfort and reduce any distressing respiratory symptoms.
Rationale: The goals of care are to provide comfort measures and reduce or eliminate any primary symptoms that may be distressing, such as respiratory distress. The treatment plan is not to cure the illness. Pain medications may be provided in the course of this plan. Attempts to keep the client out of the hospital will be a goal if the client desires to stay at home. Communication with the family and client is important to the overall plan of care.
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A patient is receiving dopamine, a vasoactive drug, to increase stroke volume for shock. The nurse should be aware of which of the following when monitoring a vasoactive drug?
A) The drug should be discontinued immediately after blood pressure increases. B) The drug dose should be weaned prior to discontinuation. C) The drug may cause respiratory alkalosis. D) The drug reduces oxygen demands of the heart.
Which of the following surgical procedures is associated with more severe wound pain?
A. Cranial surgery B. Leg surgery C. Neck surgery D. Upper abdominal surgery
LG, age 58 years, has a chief complaint of diffuse, crampy abdominal pain, which has progressed to a severity scale of 7 of 10 . He is afebrile and denies nausea, vomiting and diarrhea
Family history is positive for intestinal polyps, diabetes mellitus, and Alzheimer disease. His past medical history is positive for kidney stones, gastroesophageal reflux disease, and hypercholesterolemia. The physical examination is positive for guarding and tenderness in the epigastric region but is otherwise normal. In an effort to confirm your hypothesis, you should schedule a(n): a. electrocardiogram, because you think he has referred cardiac pain. b. colonoscopy, because you think he has diverticulitis. c. flat and erect abdominal x-ray study, be-cause you think he has a perforated peptic ulcer. d. glucose tolerance test, because you think he has diabetes-related gastroparesis.
A nurse in the emergency room suspects intimate partner violence (IPV) after examining a client. Another nurse questions how often this occurs. Which response by the nurse would be most accurate?
A) 100,000 women each year seek medical care for injuries caused by intimate partner violence. B) Its incidence has surpassed that of accidents and stranger rapes and muggings. C) Of all murdered women, 15% are victims of intimate partner violence. D) One in three women treated for major injuries are victims of intimate partner violence.