The nurse is teaching the unlicensed assistive personnel (UAP) data that requires a report to the nurse when providing care to a client receiving peritoneal dialysis. Which data does not require notification to the nurse?
1. Client complaints of pain or discomfort
2. Fluid leakage from around the catheter insertion site
3. Straw-colored outflow fluid
4. Skin irritation at the catheter site
Correct Answer: 3
Straw-colored outflow fluid is normal, and would not need to be reported. The remaining data indicate a problem, and the UAP should be instructed to report them to the nurse as soon as possible.
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The nurse studying immunity understands that which are age-related changes in immune system functioning? (Select all that apply.)
a. Decreased number of lymphocytes b. Decreased number of T suppressor cells c. Atrophy of the thymic cortex d. Increased numbers of antibodies to self-antigens e. Decreased number of B cells
How are stress and substance abuse interrelated?
A. The neurotransmitters stimulated by many abused substances enhance the sense of well-being and cause the sensation of stress when the substance wears off. B. Chronic substance abuse leads to destruction of brain cells in the limbic area, causing an increased intensity of the stress response. C. Most abused substances are perceived by the body as physiologic stressors, which result in a heightened "fight-or-flight" response. D. As tolerance or addiction develop, more of the abused substance is needed to achieve the same pleasurable responses.
Which option provides information that allows an individual to identify the patient's affective state?
a. Mr. B states that he is in considerable pain, about 8 on a scale of 1 to 10. He characterizes the pain as stabbing. b. Mrs. T's facial expression looks sad. Tears well up in her eyes, and the corners of her mouth droop. c. Miss L lies still with her eyes shut, her arms held rigidly at her side, and her fists clenched. d. Mr. A listens carefully to the directions for blood glucose monitoring and then asks several relevant questions.
A nurse is assessing a 27-week, premature neonate. The nurse notes that the premie's testicles are not descended. The nurse should anticipate which order?
1. Genetic testing 2. A pediatric urologist consultation 3. Preparing the child for immediate surgery 4. Testing for cancer