The nurse is examining a client with dark skin. In assessing for pallor, at which of the following will the nurse specifically look?
a. Lips and tongue
b. Skin creases and folds
c. Hard palate
d. Sclera
A
Pallor is more easily seen in the palms, soles, lips, tongue, earlobes, and nail beds.
Skin creases and folds are darker than the rest of the body in the dark-skinned client.
The hard palate is not a good site to assess for colour changes such as pallor.
The best site to inspect for jaundice, not pallor, is the sclera.
You might also like to view...
The nurse is performing wellness checks at a community center for older adults. Which person would the nurse evaluate as having the highest risk of stroke?
a. White, 55 years of age, BP 148/92 mm Hg b. African-American, 70 years of age, BP 150/100 mm Hg c. Asian-American, 40 years of age, BP 146/78 mm Hg d. White, 74 years of age, BP 150/82 mm Hg
A client comes to the occupational health nurse complaining of eye irritation. The client works in a dusty, outdoor environment. Why should the nurse advise periodic blinking to this client?
A) To control the amount of sunlight that enters the eye B) To minimize the impact of the wind on the eye and to trap foreign debris C) To clear the dust and particles from the surface of the eyes D) To prevent the collection of tears over the surface of the eye
The nurse is teaching a patient with stomatitis about mouth care. What should the nurse include in this teaching?
Select all that apply. 1. Avoid tobacco and alcohol. 2. Use a saline or sodium bicarbonate rinse after every meal. 3. Consume 8 oz of yogurt or buttermilk daily. 4. Avoid cold beverages. 5. Use lemon-glycerin swabs between meals.
A full-term neonate who is 30 hours old has a bilirubin level of 10 mg/dL. The neonate has a yellowish tint to the skin of the face
The mother is breastfeeding her newborn. The nurse caring for this neonate would anticipate which of the following interventions?a. Phototherapyb. Feeding neonate every 2 to 3 hoursc. Switch from breastfeeding to bottle feeding d. Assess red blood cell count