The client with manic symptoms has impulse control problems and has threatened peers and staff. The initial nursing interventions will be to: Select all that apply
A) Teach the nonviolent coping strategies.
B) Encourage the client to use a punching bag when angry.
C) Not argue with the client.
D) Use a calm, professional, confident approach.
E) Offer a wide variety of activities as distractions.
A, C, D
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The nurse is caring for a woman with epidural anesthesia for pain control during a vaginal delivery. A risk for injury related to epidural anesthesia has been identified by the nursing staff. What interventions are appropriate for the nurse to implement related to this diagnosis? (Select all that apply.)
a. Assess leg movement and sensation before ambulating. b. Administer antibiotic as ordered. c. Observe for signs of impending birth. d. Provide sacral pressure as needed. e. Assess fetal position frequently.
The nurse is caring for a critically ill patient who has experienced multiple trauma. The patient has high levels of pain from the injury and is receiving an intravenous opioid as treatment
In managing the patient's pain, what nursing action best demonstrates understanding of other factors that exacerbate pain in the critically ill patient? A) Provide supportive care without discussing it with the patient. B) Limit visits to immediate family for a few minutes at a time. C) Minimize care tasks during normal hours of sleep. D) Give higher doses of intravenous opioid as needed.
The nurse is determining the effectiveness of community empowerment efforts. What should the nurse use as the final measure for this effectiveness?
1. Budget was not overspent. 2. Community members were included in policy making. 3. Initial data was shown to be reliable. 4. Time schedules were met.
When a patient returns from a cardiac catheterization, the nurse would expect to:
1. ambulate the patient in the hall. 2. check the puncture site. 3. monitor the gag reflex. 4. remove the gel from all sites on the skin.