Which of the following statements made by a nurse reflects the best understanding of the role of the bath in the nursing assessment process?
1. "I work with my ancillary staff to be able to determine what is abnormal."
2. "The skin is easy to observe for abnormalities when you are giving the bath."
3. "I use the time to really look at my clients and determine what's normal and what's not."
4. "Bath time is an excellent time to get to know your clients and form that nurse-client relationship."
ANS: 3
Take this time to identify abnormalities and initiate appropriate actions to prevent further injury to sensitive tissues. It also provides an opportunity to assess other systems (e.g., circulatory, res-piratory) and client behaviors as well. While the nurse is responsible for determining abnormali-ties, the ancillary staff should be instructed to report any suspicious factors they note. Answer 3 is the most thorough statement regarding the question.
You might also like to view...
Select the problem statement that meets criteria for a problem statement and contains all the necessary elements
1. Is there a difference in male body weight after exercise? 2. Is there a correlation between exercise and pulse rates? 3. Is there a correlation between perception of pain and noise level? 4. Is there a difference in insomnia between men and women?
When the dying patient becomes delirious, what should the nurse encourage the family to do?
a. Leave the room and wait outside until the delirium clears. b. Hold the patient's hand, but say nothing, because hearing stays intact until death. c. Remain near the bed and speak to the patient in loud tones to stimulate the patient. d. Touch the patient, call the patient by name, and speak in reassuring tones.
Cocaine differs from many other forms of substance abuse in that the representation of women to men is:
a. twice as high b. equal c. half as high d. unknown
The nursing student is preparing a presentation on health promotion. Which of the following activities are included in the presentation? Select all that apply
a. Teaching a group of 75-year-old adults about the influenza vaccine b. Administering a pain medication to a patient after surgery c. Developing a list of stress-management strategies d. Identifying calorie counts on all food choices in restaurants