The nurse is caring for a 54-year-old female patient on the first postoperative day after a Roux-en-Y gastric bypass procedure. Which assessment finding should be reported immediately to the surgeon?
a. Bilateral crackles audible at both lung bases
b. Redness, irritation, and skin breakdown in skinfolds
c. Emesis of bile-colored fluid past the nasogastric (NG) tube
d. Use of patient-controlled analgesia (PCA) several times an hour for pain
c. Emesis of bile-colored fluid past the nasogastric (NG) tube
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The nurse is counseling a patient about the difference between type 1 and type 2 diabetes. What should the nurse stress that patients with type 2 diabetes are required to receive on a daily basis?
a. Regular carbohydrate-controlled meals b. Oral hyperglycemic agents c. Insulin injections d. Stringent low-calorie diets
The nurse prepares to perform a dressing change. Which does the nurse apply to implement general nursing interventions for dressing changes?
1. Pack the dead space in an ulcer tightly. 2. Debride a wound with dry gauze dressing. 3. Keep the wound edges dry and ulcer moist. 4. Dry wound bed to stimulate granular tissue.
A nurse is considering the delegation of administering medications to an unskilled assistant. What is the first question the nurse must ask herself before doing so?
A) Has the assistant been trained to perform the task? B) Have I evaluated the patient's response to this task? C) Is the delegated task permitted by law? D) Is appropriate supervision available?
A child with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. Which is the priority intervention for this child?
What will be an ideal response?