A 71-year-old patient had an abdominal-perineal resection for colon cancer. Which nursing action is most important to include in the plan of care for the day after surgery?
a. Teach about a low-residue diet.
b. Monitor output from the stoma.
c. Assess the perineal drainage and incision.
d. Encourage acceptance of the colostomy stoma.
c. Assess the perineal drainage and incision.
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A nurse is educating a woman who is 38 years old and experiencing her first pregnancy. When planning care for this woman, what information does the nurse take into consideration? (Select all that apply.)
A. Chronic health conditions are more likely in this age group. B. Genetic screening is not recommended for women over age 30. C. Gestational diabetes is seen more frequently in this age group. D. Multiple gestations are rarely seen in women over age 35. E. Older primigravidas are at higher risk for cesarean birth.
Subjective data provided by the patient included complaints of intermittent chest pain upon exertion. When performing a complete physical examination, the nurse might use an organized approach such as:
a. Maslow's hierarchy of needs. b. a head-to-toe assessment. c. subjective data collection. d. objective data collection.
Which are signs and symptoms of fluid overload in a patient receiving diuretics? (Select all that apply)
a. Changes in cardiac and lung sounds b. Increase in daily weight c. Decrease in daily weight d. Dry skin
A patient of Japanese heritage avoids asking for narcotics for pain relief. The nurse writes a nursing diagnosis of Pain related to reluctance to take medication secondary to cultural beliefs. If the cultural archetype is true for this particular patient,
this probably means that the patient views pain as: a. A punishment for immoral behavior b. An expected, normal part of life c. Best treated with herbal teas and prayer d. A virtue and a matter of family honor