A nurse has completed data analysis. Which of the following would the nurse identify first as the result?
A) Outcome evaluation
B) Nursing diagnosis
C) Interventions
D) Plan of care
B
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Burn shock, a form of hypovolemic shock, is largely a process of
A) fluid shifts from the burn area into the vascular space. B) fluid loss at the burn site. C) fluid shifts from the vascular space into the interstitial areas of the burn wound. D) extensive bleeding secondary to debridement.
After cardiac surgery, a child has chest tubes inserted that are attached to an underwater-seal drainage system. You should be prepared to clamp chest tubes when
A) a clot obstructs the tubing. B) a tube becomes disconnected. C) red-stained drainage appears in a tube. D) you sit the child up to help with coughing.
A nurse reviews a patient's care plan and finds a goal for the patient to ambulate at least three times a day. The nurse assists the patient to accomplish this goal. The nurse is participating in which step of the nursing process?
a. Planning b. Evaluation c. Data collection d. Implementation
A patient, age 27, sustained thermal burns to 18% of her body surface area. After the first 72 hours, the nurse will have to observe for the most common cause of burn-related deaths, which is:
a. shock. b. respiratory arrest. c. hemorrhage. d. infection.