A patient's nursing diagnosis is sleep-pattern disturbance. The desired outcome is: Patient will sleep for a minimum of 5 hours nightly by October 31
On November 1, review of sleep data for 6 days shows the patient slept an average of 4 hours nightly and took 2-hour afternoon naps daily. Which evaluation should be documented? a. Consistently demonstrated
b. Often demonstrated
c. Sometimes demonstrated
d. Never demonstrated
D
Although the patient is sleeping 6 hours daily, uninterrupted sleep was not achieved. Therefore, the outcome was never demonstrated.
You might also like to view...
A patient had an open reduction with internal fixation (ORIF) for a compound fracture of the left tibia and has been placed in a long leg cast
The assessments by the nurse are: left foot warm/pink, pedal pulse weaker than right, capillary refill 3 seconds, and small 1 cm area of blood on cast. What should the nurse do? a. Notify charge nurse of impending compartment syndrome b. Document that all assessments are within normal limits c. Inform charge nurse about probable hemorrhage d. Place warm compresses on left foot
A patient is scheuled for a myelogram. The nurse explains to the patient that this is an invasive procedure, which assesses for any lesions in the spinal cord
The nurse knows that the preparation is similar to which of the following neurological tests? A) Lumbar puncture B) Magnetic resonance imaging (MRI) C) Cerebral angiography D) Electroencephalography (EEG)
A patient will begin taking propranolol [Inderal] for hypertension. Which statement by the nurse is important when teaching this patient about the medication?
a. "Check your hands and feet for swelling and report that to your provider." b. "It is safe to take this medication with a calcium channel blocker." c. "Stop taking the drug if you become short of breath." d. "Take your pulse and do not take the me-dication if your heart rate is fast."
The nurse will advise the parents of a child who has a hearing loss that communication can best be enhanced by doing which of the following?
a. Speak somewhat louder and much slower than you would to a hearing person. b. Get the child's attention and look into the child's face at eye level. c. Hold the child's hands while speaking to her. d. Reduce or eliminate body gestures.