A resident has dementia. The person is restless and is grunting and groaning. You know that the behaviors are:
a. Signs and symptoms of pain
b. Related to dementia
c. Cultural responses
d. Related to anxiety
A
You might also like to view...
A 16-year-old client has a long leg cast secondary to a fractured tibia. The child will require a wheelchair for mobility. To effectively facilitate the adolescent's return to school, the school nurse should:
1. Meet with all of the other students prior to the student's return to school to emphasize the special needs of the injured teen. 2. Meet with teachers and administrators at the school to discuss modifications in the student's school routine. 3. Develop an individualized health plan (IHP) focusing on long-term needs of the adolescent. 4. Meet with parents of the injured student to encourage homebound schooling until a short leg cast is applied.
A nurse caring for an older client on a medical-surgical unit notices the client reports frequent constipation and only wants to eat softer foods such as rice, bread, and puddings. What assessment should the nurse perform first?
a. Auscultate bowel sounds. b. Check skin turgor. c. Perform an oral assessment. d. Weigh the client.
A nurse is planning preoperative teaching for a client with conductive hearing loss due to otosclerosis
The client is scheduled for a stapedectomy with insertion of a prosthesis. What information is most crucial to include in the client's preoperative teaching? A) 35% of clients will not experience restoration of hearing. B) Noticeable improvement in hearing may not be experienced for up to 6 weeks after surgery. C) The nurse must assist the client to get out of bed on the first postoperative day. D) Close-captioned TV programs are available at the hospital to meet the needs of hearing-impaired clients.
Care of the client with a suprapubic catheter includes the:
A. Use of clean technique B. Connection of the tubing to a small abdominal drainage bag C. Cleansing of the insertion site in a direction toward the drain D. Promotion of 1500 ml of fluid per day for a client without restrictions