The nurse is caring for a patient with reduced perfusion to the extremities. The nurse evaluates the patient and finds the response to therapy is not optimal. What lifestyle change does the nurse suspect is contributing to the lack of response?
a. Following a vegetarian diet
b. Taking daily brisk walks
c. Ingesting 1,500 mL of fluid per day
d. Smoking cessation when the diagnosis was received
C
1,500 mL of fluid is lower than optimal and the patient should be encouraged to increase fluid intake to 2,000 mL per day. This could have a negative impact on perfusion if the patient is dehydrated, even mildly so. A vegetarian diet is usually low in cholesterol and fat, so this is an appropriate lifestyle change that would not reduce response to therapy. Further assessment of diet may be needed. Daily exercise promotes perfusion, so this would not be the anticipated cause of reduced response to therapy. Quitting smoking should improve response to therapy and would not be the likely cause of the patient's failure to respond to treatment.
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The patient's record, laboratory studies, objective data, and subjective data combine to form the:
a. Data base. b. Admitting data. c. Financial statement. d. Discharge summary.
A patient states, "I'm starting cognitive-behavioral therapy. What can I expect from the sessions?" Which response(s) by the nurse would be appropriate? Select all that apply
a. "The therapist will be active and questioning." b. "You may be given homework assignments." c. "The therapist will ask you to describe your dreams." d. "The therapist will help you look at ideas and beliefs you have about yourself." e. "The goal is to increase subjectivity about thoughts that govern your behavior."
Which laboratory finding would the nurse expect in an older patient diagnosed with multiple myeloma?
1. Increased calcium level 2. Increased white blood cells 3. Decreased blood urea nitrogen level 4. Decreased number of plasma cells in the bone marrow
Explanation: 1. Polypharmacy is a major factor in hospital readmission rates due to unnecessary adverse events. The nurse teaches ways in which the client can avoid readmission to the hospital, including how to take medications as prescribed. 2. There is not enough information to determine if the client is prone to missing medication doses. The nurse does suggest ways in which the client can
keep the medications and doses on a regular schedule, such as using a pill planner. 3. Although the client may have multiple conditions that warrant the medications prescribed, it is the job of each provider to obtain a thorough history. Additionally, pharmacists should alert the client and provider to any interaction potentials. 4. Cognitive impairments do occur when clients are on numerous medications. The nurse ensures the client understands their medication regimen and side effect management. 1. Dexamethasone 2. Ketorolac 3. Fluconazole 4. Phenobarbital 5. Atenolol