A nurse assesses a client who is recovering from a lumbar laminectomy. Which complications should alert the nurse to urgently communicate with the health care provider? (Select all that apply.)
a. Surgical discomfort
b. Redness and itching at the incision site
c. Incisional bulging
d. Clear drainage on the dressing
e. Sudden and severe headache
ANS: C, D, E
Bulging at the incision site or clear fluid on the dressing after a laminectomy strongly suggests a cerebrospinal fluid leak, which constitutes an emergency. Loss of cerebral spinal fluid may cause a sudden and severe headache, which is also an emergency situation. Pain, redness, and itching at the site are normal.
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A) At times that the client selects, as long as they are 8 hours apart B) At 9 a.m., 3 p.m., and 9 p.m. C) Whenever the client chooses, as long as it gets done three times daily D) After breakfast, lunch, and dinner
A client has laboratory studies that determine he is deficient in copper. What does the nurse understand is the importance of copper in the body?
A) Essential for the maturation of red blood cells B) Basic nutritional component of heme in hemoglobin C) Involved in the transfer of iron from storage to plasma D) Serves as a coenzyme in hemoglobin formation
The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. What should the nurse recommend?
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Which best describes a nurse's use of assertive behavior?
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