The nurse is conducting discharge teaching to parents regarding care of the umbilical cord. Which should the nurse include in the instructions? (Select all that apply.)
a. Cover the umbilical cord with the diaper.
b. The cord will fall off in 5 to 15 days.
c. Clean around the umbilical cord stump with water.
d. Watch for redness and drainage around the umbilical cord stump.
e. A tub bath can be done every other day.
ANS: B, C, D
The umbilical cord is cleansed initially with sterile water or a neutral pH cleanser and then subsequently with water. The stump deteriorates through the process of dry gangrene, with an average separation time of 5 to 15 days. The umbilical cord area should be watched for redness or drainage, which could indicate infection. The diaper is placed below the cord to avoid irritation and wetness on the site, and tub bathing is not allowed until the umbilical cord falls off
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The nurse identifies factors that can cause errors in blood pressure measurement that yield higher results, such as: Standard Text: Select all that apply
1. Use of an electronic blood pressure device. 2. Use of an aneroid sphygmomanometer. 3. Use of a Doppler ultrasound stethoscope. 4. A blood pressure cuff that is too small for the diameter of the client's arm. 5. A blood pressure cuff that is too long.
An elderly patient in the CCU is getting out of bed for the first time after being on bed rest for several days. What is the highest-priority nursing intervention?
A) Provide adequate physical help so that the patient does minimal weight bearing. B) Ensure that the patient's call light is always within reach. C) Apply a vest restraint while the patient is up to prevent falling. D) Have the patient sit on the side of the bed for a few minutes before standing.
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Which of the following is important for the nurse to consider in selecting the design and layout of a critical appraisal tool?
a. Design and layout differ but measure the same areas. b. Design and layout differ, and reliability measures differ. c. Design, layout, and reliability are similar but relevancy differs. d. Design, layout, and reliability differ but trustworthiness is the same.