The nurse recognizes that the client with gallstones who would be the best candidate for treatment with extracorporeal shock wave lithotripsy (ECSL) is a client with
a. common bile duct stones.
b. liver disease.
c. stones that are 6 cm in diameter.
d. two gallstones.
D
The client should have symptomatic cholelithiasis with fewer than four stones, each smaller than 3 cm in diameter, and no history of liver or pancreatic disease. Contraindications to ECSL are the presence of common bile duct stones, recent acute cholecystitis, cholangitis, and pancreatitis.
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The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of:
a. a percutaneous catheter at the bedside. b. a percutaneous tunneled catheter at the bedside. c. an arteriovenous fistula. d. an arteriovenous graft.
Nurses might evaluate their beliefs, values, and knowledge about poverty by being placed in which of the following situations?
1. A client asking for a small amount of money at a clinic 2. Setting up a homeless shelter 3. Making a home visit to a home that is unkempt 4. Reading about poverty in a textbook
What are three major issues with mHealth applications and wearable devices?
Case study Last month you were hired with the title Health Informatics Specialist at an independent community care hospital with 350 beds. The hospital includes a comprehensive outpatient clinic, a rehabilitation center with both inpatient and outpatient services, a cardiac care center, and an emergency room. In addition, four family health centers are located throughout the community. More than 930 primary care and specialty physicians are associated with the hospital, which has a staff of just over 2000 employees. The hospital has an EHR in place. The hospital has a working relationship with a major academic medical center located 23 miles away. Acute care patients who need more extensive treatment are usually transferred to the medical center. These are often emergency situations, and data are freely shared among the institutions with the best interests of the patient in mind. Located directly beside the hospital is a 194-bed skilled nursing home. While the nursing home has its own medical staff consisting of a physician and two nurse practitioners, patients needing consults or additional care are usually seen at the hospital with follow-up at physicians’ offices. While the nursing home, most of the physicians’ offices, and the hospital are independent institutions, there is a long history of sharing health-related data when treating patients who live at the nursing home and are seen at the hospital or in the physicians’ offices. This coordination is seen as a general benefit for a number of patients. It appears that most patients have signed a form giving the hospital permission to send information to the nursing home. However, these forms have been stored in individual offices, so it is difficult to determine who has signed what forms and what permission has or has not been given to share information among the nursing home, hospital, and independent medical practices.
A client is scheduled for surgery under general anesthesia. The night before surgery, the client tells the nurse, "I can't wait to have breakfast tomorrow." Based on this statement, which nursing diagnosis should be the nurse's priority?
a) Deficient knowledge related to food restrictions associated with anesthesia b) Fear related to surgery c) Risk for impaired skin integrity related to upcoming surgery d) Ineffective coping related to the stress of surgery