The nurse is admitting a 50-year-old female who was involved in a car accident and whose only injuries were burns over 50% of her body. Identify the highest-priority nursing diagnosis for this patient
1. Acute Pain
2. Coping: Family, Compromised
3. Disturbed Body Image
4. Deficient Fluid Volume
4
Rationale 1: Acute Pain is an important nursing diagnosis but does not have the highest priority.
Rationale 2: Family coping will probably be compromised and the nurse should address this issue. However, this is not the priority diagnosis.
Rationale 3: Disturbed Body Image is an important nursing diagnosis but is not the highest priority.
Rationale 4: Immediately after a burn injury, fluid begins to shift from the intracellular and intravascular compartment into the interstitial space. This third-spacing of fluid, if left untreated, will lead to hypovolemia and burn shock, which is life threatening. Also, edema develops in unburned tissues and organs distant from the site of injury when the burn size exceeds 20% of total body surface area.
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Which quality improvement initiatives would help the health care organization meet Institute of Healthcare Improvement (IHI) goals? Note: Credit will be given only if all correct choices and no incorrect choices are selected
Standard Text: Select all that apply. 1. The amount of material opened and wasted for surgical procedures will drop by 25 percent this fiscal year. 2. The number of nurses who hold a bachelor's degree will increase by 10 percent this year. 3. Wait times in the emergency department will decrease by 15 percent this year. 4. Employee absences will drop by 10 percent this year. 5. Fewer than 5 percent of clients will report inadequate pain control while hospitalized.
When caring for a woman who was sexually assaulted, what is your best approach for collecting information surrounding the event? Select all that apply
a. Use a calm, reassuring voice when asking questions of your patient. b. Ask only close family members to describe events related to the incident. c. Provide privacy by asking questions behind a closed curtain. d. Document the details using the patient's own words.
A Hispanic client comes to the hospital in pain and is admitted to the ER due to cholecystitis. The client does not speak any English. An interpreter had been used during the course of treatment, and now the client is ready to be discharged
Which of the following technologies best assists the nurse in client teaching during the discharge process for a client such as this? A) Care plans generated by software programs based on nursing diagnosis B) Computerized documentation through the use of hand-held computers C) Software that translates teaching materials into multiple languages D) Software allowing access to x-rays in digital format to be read by radiologists
A hypertensive female patient being treated with which of the following would be of primary concern if she became pregnant?
1. Enalapril (Vasotec) 2. Potassium supplement 3. Doxazosin (Cardura) 4. Hydrochlorothiazide (HCTZ)