Describe the potential adverse events that might occur in this circumstance
You have ‘scrubbed-in' to take over the instrument nurse role for a patient undergoing a complex breast reconstruction involving a latissimus dorsi free flap. The procedure is at the mid-way point when you scrub in. The instrumentation set-up has multiple receivers (i.e. gallipots) and syringes containing a variety of fluids, which your colleague identifies as local anaesthetic, heparinised saline and adrenaline solutions. None of the containers or syringes is labelled.
What will be an ideal response?
Answer:
Misidentification of the substances leading to administration of the wrong medication or via the wrong route, allergic reaction/anaphylaxis, contraindication, incorrect effect, undesired effect, coagulopathy, vasoconstriction, local anaesthetic toxicity, arrhythmia and cardiac arrest, as well as the potential for adverse surgical outcomes such as failure of the free flap/graft.
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The nurse is planning care for a child with chickenpox (varicella). Which prescribed supportive measures should the nurse plan to implement? (Select all that apply.)
a. Administration of acyclovir (Zovirax) b. Administration of azithromycin (Zithromax) c. Administration of Vitamin A supplementation d. Administration of acetaminophen (Tylenol) for fever e. Administration of diphenhydramine (Benadryl) for itching
A client who is experiencing a crisis is admitted to a nursing unit. When entering the client's room, the nurse should attempt to establish rapport and engage the client by
a. offering a brief introductory statement to quickly orient the client to the purpose of crisis questions. b. demonstrating an inflexible approach when caring for the client. c. placing the client in a dimly lit room close to the nursing unit. d. delegating to several nurses the role as primary contact for information.
A client has chosen to discontinue hemodialysis. His family is not supportive of his decision. The nurse who uses the theory of principles-based reasoning would make which of the following statements?
1. "This client is of sound mind and is capable of making his own decisions regarding health care. It really is his decision to make." 2. "I need to try and help the family understand the client's decision so they can work through this situation together." 3. "This client's health is so deteriorated that the treatment is not saving his life. It is prolonging the ultimate outcome, which is his death." 4. "The client understands his decision and the advanced stage of his disease. If he quits treatment, he will die."
Which of the following assessment findings might indicate elder self-neglect?
a. Hesitancy to talk openly with nurse b. Inability to manage personal finances c. Missing valuables that are not misplaced d. Unusual explanations for injuries