A nurse is assessing an 11-month-old, and notes that the infant's height and weight are at the 5th percentile on the growth chart

Family history reveals that the infant's two siblings are at the 50th percentile for height and at the 75th percentile for weight. Psychosocial history reveals that the parents are separated and are planning to divorce. Which of these nursing diagnoses takes priority? 1. Nutritional Intake: excessive secondary to maternal feeding patterns

2. Growth Pattern, Altered secondary to familial short stature

3. Growth Pattern, Altered related to parental anxiety

4. Constitutional Growth Delay, risk for related to decreased appetite


3
Rationale:

1. Since height and weight are at the 5th percentile, there is no indication of increased nutritional intake.
2. There are no data that indicate familial short stature.
3. The scenario reveals parental anxiety due to marital problems. The most appropriate nursing diagnosis is Growth Patterns, Altered related to parental anxiety.
4. This infant is not at risk for constitutional growth delay.

Nursing

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A patient in the ICU is receiving an intravenous opioid infusion for pain, but is experiencing anxiety due to being on mechanical ventilation. The physician has decided to prescribe a sedative for the patient

The patient's health history indicates an allergy to soy products. Which sedative should be avoided in this situation? A) Propofol B) Midazolom C) Diazepam D) Lorazepam

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A nurse has participated in organizing a blood donation drive at a local community center. Which of the following individuals would most likely be disallowed from donating blood?

A) A man who is 81 years of age B) A woman whose blood pressure is 88/51 mm Hg C) A man who donated blood 4 months ago D) A woman who has type 1 diabetes

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The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication?

a. Aspirin b. Heparin c. Warfarin d. Erythropoietin

Nursing

What is the best nursing response when a patient asks, "What do you know about massage therapy? A friend of mine says it can be more helpful than antidepressants."

a. "The research has shown that massage is very beneficial, so this is a good question for you to ask your doctor. Why not bring up the topic with your psychiatrist today during your visit?" b. "While a few research studies indicate that massage will help relieve depression and anxiety, it's effective for only a short time, and no studies have compared massage with medication.". c. "I know very little, because there really is no current research available on the effectiveness of massage. However, many of these new therapies can do damage, so I wouldn't do it.". d. "I know very little, because there are few research findings on the effectiveness of massage. It certainly can't hurt, and it might help, so why not try it?"

Nursing