A patient is admitted after traumatic amputation of the left leg just below the knee. This crushing injury occurred at work while the patient was taking a smoking break
The nurse provides care based on which knowledge? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Crushing injuries are usually suitable for reattachment of the limb.
2. The patient's report of pain in the area of the amputated foot is real.
3. Smoking is a significant risk factor for impaired healing of reattached limbs.
4. The recovery period for a limb reattachment would be similar to that for a surgical amputation.
5. Nerve regeneration to a reattached lower limb usually results in poor function.
2,3,5
Rationale 1: Reattachment in crush-type amputations is not attempted due to the poor outcome.
Rationale 2: The patient may have bizarre sensations, such as feeling as if the absent foot is cold or itchy. These are called phantom limb sensations.
Rationale 3: Reattachment may not be attempted in patients who smoke because of the risk of impaired healing.
Rationale 4: Complete amputation and prosthesis could allow a patient to return to normal activities in days to weeks, whereas reconstruction of mangled limbs can span years, with a huge psychological strain and impact on function and occupation.
Rationale 5: Surgical reattachment of a severed limb is done only under certain circumstances because the surgery is difficult. For adults, it is nearly impossible for nerves to regenerate in the lower extremity, and the reattached limb may be painful and dysfunctional.
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Which of the following patients has an absolute neutrophil count that is critically low and that the standard of care would recommend they be placed on neutropenic precautions?
A) A patient on long-term steroids for rheumatoid arthritis with WBC of 7000 B) A 37-year-old patient with leukemia being treated with chemotherapy with ANC of 400 C) A 65-year-old prostate cancer patient receiving radiation therapy with neutrophil count of 2000 D) A 75-year-old renal failure patient receiving Epogen for anemia with hemoglobin level of 9.7.
The nurse is educating a young female college student about STIs
The nurse would evaluate that teaching goals have been met when the student makes which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "Women between 14 and 25 have a particularly high risk of contracting an STI.". 2. "STIs can be transmitted from me to my unborn baby.". 3. "Oral contraceptives do not protect against STIs.". 4. "STIs are easy to diagnose.". 5. "Sexual activity with multiple partners is associated with an increased incidence of STIs.".
The client is having difficulty falling asleep. Which does the nurse implement to facilitate relaxation and sleep?
1. Offer a soothing back massage with lotion. 2. Report client difficulty to oncoming nurses. 3. Assess for physical or cultural sleep factors. 4. Tell client to recline in bed and read quietly.
Hank is a 52-year-old professional who has type 2 diabetes. He is very health conscious and carefully follows his diet and exercises regularly. He has good glycemic control and his BMI is < 25
When reviewing his medication list, the nurse notices that he has numerous vitamins and natural supplements listed. He tells her that he spends about $300 online each month for these items. The best response for the nurse would be: 1. Vitamins and other supplements that are "natural" are safe for consumers to use. 2. Extra vitamins and minerals are not routinely recommended for clients with diabetes unless there is an special medical reason. 3. Taking extra vitamins is a good practice, but supplements may interact with other medications. 4. Only the B vitamins have been shown to result in improvements with glucose control.