A patient with critical illness on complete bed rest has been without oral intake for several days. The patient's general instability has prevented routine turning and repositioning for the past 24 hours
The patient's weight has increased by 10 pounds since admission and the nurse notices evidence of skin breakdown starting. What is the most likely cause of this breakdown?
A) Protein–calorie malnutrition
B) Hazards of immobility
C) Peripheral edema formation
D) Effects of medications
A
You might also like to view...
A mother of a 2-month-old is worried about a "soft spot" on the top of her infant's head. The nurse informs her that this is a normal physical finding called the anterior fontanelle, and that it will remain open until:
1. 2–3 months of age. 2. 6–9 months of age. 3. 12–18 months of age. 4. Approximately 2 years of age.
Case management is a practice model that was developed to:
a. provide supervision for a team of nurses who are working independently b. minimize fragmentation of services and maximize individualization of care c. reduce costs of health care through better organization of care d. track large numbers of cases supervised or served by a health care organization
P.C. confides that she has not formally written down her wishes concerning what types of treatments she
would or would not want. You advise her to complete an advance directive, a living will, and a medical durable power of attorney or surrogate decision maker form. How would you describe the purpose of these documents to her?
When planning patient care, a goal can be described as
a. A statement describing the patient's accomplishments without a time restriction. b. A realistic statement predicting any negative responses to treatments. c. A broad statement describing a desired change in patient behavior. d. An identified long-term nursing diagnosis.