Which of the following is the best example of the implementation phase of the nursing process?
a. Patient verbalizes pain is reduced from an 8 to a 3 after receiving pain medication.
b. Nurse observes that patient has a small, quarter-sized skin tear over coccyx area.
c. Nurse writes in the care plan: Patient requires 2 person assist with ambulation to bathroom.
d. Nurse inserts Foley catheter after reporting to physician patient's inability to void.
D
Implementation is the action phase of the nursing process. It involves thinking but the emphasis is on doing. During implementation, the nurse will perform or delegate planned interventions. In short, implementation is doing, delegating, and documenting. A patient verbalizing that pain is reduced after receiving pain medication is part of the evaluation phase. Observing or noticing a skin tear relates to assessment and evaluation of skin condition. Writing on the care plan of a patient requiring assistance to the bathroom is an example of assessment and planning.
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A patient with acute kidney injury (AKI) demonstrates blue mottling of the skin in her fingers. What other finding would tend to indicate that the cause of this condition is intrarenal?
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a. assault c. felony b. battery d. misdemeanor
The wife of a patient you are caring for asks to speak with you. She tells you that she is concerned because her husband is requiring more and more pain medication
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