The skin receives stimuli from the outside world, providing a dynamic interaction between external and internal environments
Based on this information, what is the best nursing action that a nurse can implement for a client who has a loss of sensation to the integumentary system? A) Be careful when handling the arms of clients.
B) Inspect for skin tears.
C) Inspect skin frequently, especially bony prominences.
D) Discourage smoking and exposure to the sun.
C
Feedback:
When an individual has loss of sensation, it is important to inspect the skin frequently, especially bony prominences. When the capillary bed in the dermis becomes more friable, the nurse should be careful when handling the arms of clients. When the epidermal and dermal layers flatten, the nurse should inspect for skin tears. When there is a loss of elasticity in the dermis, loss of subcutaneous layer of fat, and loss of collagen fibers, the client should be discouraged from smoking and exposure to the sun.
You might also like to view...
In writing out a list of medications for a patient, which statement would be best?
a. Lasix, 20 mg po once a day in the morning b. Lasix, 20 mg in the morning c. Lasix, 20 mg qd d. Lasix, 1 tablet by mouth every morning after breakfast.
The rehabilitation nurse references the nursing diagnosis of impaired cognition for a 40-year-old patient who is brain injured and who:
a. frequently becomes violent. b. becomes easily fatigued. c. is depressed. d. cannot add three numbers in his head.
A nurse is administering a patient's medication by mouth. The nurse knows that for this medication to be utilized by the body, diffusion, filtration, and osmosis must take place. Which mechanism is the first to be involved in that process?
a. Excretion b. Metabolism c. Distribution d. Absorption
A Hispanic patient in the hospital has been told that medication is recommended for his condition. He tells the nurse that he would like to consult the curandera before making a deci-sion. The nurse will first:
1. talk with the patient about his cultural beliefs related to health. 2. inform the physician of the patient's request. 3. restrict contact between the patient and the curandera. 4. talk with the family about the request.