As part of nursing management of a critically ill patient, orders are written to keep the head of the bed elevated at 30 degrees, awaken the patient from sedation each morning to assess readiness to wean from mechanical ventilation, and implement
oral care protocols every 4 hours. These interventions are done as a group to reduce the risk of ventilator-associated pneumonia. This group of evidence-based interventions is often called a: a. bundle of care.
b. clinical practice guideline.
c. patient safety goal.
d. quality improvement initiative.
A
A group of evidence-based interventions done as a whole to improve outcomes is termed a bundle of care. This is an example of the ventilator bundle. Oftentimes these bundles are derived from clinical practice guidelines and are monitored for compliance as part of quality improvement initiatives. At some point, these may become part of patient safety goals.
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A nurse explains that type 1 diabetes mellitus is a disease in which the body does not produce enough insulin. What is the reason that the blood glucose is elevated?
a. Prolonged elevation of stress hormone (cortisol, epinephrine, glucagon, growth hormone) levels b. Malfunction of the glycogen-storing ca-pabilities of the liver c. Destruction of the beta cells in the pan-creas d. Insulin resistance of the receptor cells in the muscle tissue
A client has chosen to undergo a simple mastectomy for stage I breast cancer. Which response below best describes this surgical procedure?
a. removal of the tumor mass and a small por-tion of adjacent tissue b. removal of only the cancerous mass c. removal of the entire breast, lymph nodes, and underlying muscle d. removal of the entire breast and lymph nodes
The nurse is caring for an 80-year-old patient who has Alzheimer's disease who will begin taking rivastigmine (Exelon). What will the nurse include in the plan of care for this patient?
a. Administer the drug once daily. b. Assist the patient to stand and walk. c. Give the drug with food to increase absorption. d. Use nonsteroidal anti-inflammatory drugs (NSAIDs) instead of acetaminophen for pain.
A patient calls the clinic in a panic because she discovers she is pregnant after having unprotected sex
Shortly thereafter the patient ingested alcohol and acetaminophen. She is concerned about causing damage to the fetus. What should the nurse respond to the patient? A) "Why did you have unprotected sex if you had been drinking?" B) "You didn't know you were pregnant, so you haven't done anything wrong. The fetus isn't exposed to the mother's blood until after it implants, so the wedding's not an issue. But, don't have any more alcohol while you're pregnant." C) "Exposure to alcohol can cause facial deformities, low birth weights, and underdeveloped brains." D) "You didn't know you were pregnant, so you haven't done anything intentionally wrong. But alcohol is very damaging to the growing fetus, so you'd better be sure to stop drinking. Do you need any support for that?"