The nurse is caring for a client who is intubated following trauma to the chest. Which of the following nursing measures would the nurse perform while the client is intubated?
A) Provide oral care every 4 hours.
B) Monitor placement of the endotracheal tube.
C) Keep the client lying flat to prevent tube slippage.
D) Perform chest compressions every 5 minutes.
B
Feedback:
While the client is intubated, nursing care consists of providing oral care every 2 hours, monitoring respiratory status and placement of the ET (it can slip out of position), and repositioning the client to prevent hazards of immobility (e.g., pneumonia). Chest compressions are performed with CPR.
You might also like to view...
The nursing student is planning to study all weekend for a final exam scheduled on Monday. Is this a good strategy for study?
1. Yes; this method will assure all material is fresh in the student's mind. 2. No; the student should plan on an all-night study session on Sunday night only. 3. Yes, but the best strategy is to invite six or seven fellow students to join in the session. 4. No; study should be incremental across the semester with a general review the day before the exam.
As the United States moves towards the implementation of an interoperable EHR, which statement about the future ownership of the patient record is appropriate?
a. The electronic medical record will be the property of the service institution. b. Provider access to the electronic record would not require consumer consent. c. Ownership may be driven by who has control and access to the data. d. Consumers will control and own the record.
Which statement is true about current economic statistics regarding poverty in the United States?
a. The elderly are more likely to live below the poverty level. b. Women who are the head of the household often have low incomes. c. The financial welfare of children has continued to improve. d. Poverty continues to be a problem in families where both parents work.
The nurse is reviewing the client's medical record, and finds that the client consistently has had significantly more intake than output for the past four days
When reading the previous shift's assessment, the nurse learns the client had audible rales in the bases of the lungs. The nurse concludes that the client's medical diagnosis of congestive heart failure is exacerbated by fluid overload. The nurse has demonstrated the use of: A) reasoning. B) inductive reasoning. C) deductive reasoning. D) intellectual empathy.