The client being prepared for a procedure asks to be allowed to wear a religious medal. The client states, "I have worn this medal and have not removed it since I was a teenager." What action should the nurse take?
1. Tell the client that the medal must be removed, as it is policy to remove all jewelry for these procedures.
2. Tell the client that the medal can be worn.
3. Tell the client that the nurse will explain to the procedure staff about the medal and will request that they allow the client to wear it.
4. Remove the medal and place it on the head of the bed where the client will be able to see it during the procedure.
Correct Answer: 3
Rationale 1: The fact that there is a policy to remove all jewelry is simply a policy, and an exception might be made and documented in this case.
Rationale 2: The nurse should not tell the client that the medal will be allowed, as this decision belongs to those directly involved in the procedure.
Rationale 3: The nurse should explain the significance of the medal to the procedure staff and request that the client be allowed to wear it during the procedure.
Rationale 4: Removing the medal and placing it on the head of the bed is not a good choice. There may be no reason to remove the medal. Placing the medal on the head of the bed might allow it to be lost.
You might also like to view...
The patient has had coronary artery bypass surgery involving the cardiopulmonary bypass pump, systemic hypothermia, topical cardiac hypothermia, and cold cardioplegia
As a result of the various hypothermic therapies, numerous postoperative complications may ensue. What collaborative postoperative intervention is specifically directed at ameliorating one or more of these complications? A) Use of intravenous pain and sedation medications B) Mechanical ventilation and supplemental oxygen therapy C) Vital signs every hour until stable or transferred to step-down unit D) Management of mediastinal chest tube drainage
Treatment for a child with allergic rhinitis includes which of the following? (Select all that apply.)
a. removing drapes and using blinds on windows b. using down bedding c. using dustcovers on beds d. avoiding wool bedding e. using hardwood floors f. keeping pets indoors
The school nurse reviews basic information collected during routine health checks of the students. Which action should the nurse take to help reduce the number of students with a body mass index of 30 or greater?
a. Prepare a handout on healthy food choices b. Send letters to all parents about the obesity epidemic in the school c. Suggest time for physical activity be increased in the course curriculum d. Schedule time with each overweight student and counsel on the hazards of obesity
A preterm infant of 32 weeks is being started on formula. When planning care for her, you anticipate that the formula used most likely will be
A) diluted with glucose water. B) a 20 cal/oz formula. C) a 24 cal/oz formula. D) an iron supplemental formula.