A patient is admitted for hip surgery. The patient usually takes the following medications daily: an anticoagulant, a multivitamin, and vitamin E 1,500 IU. He stopped taking his anticoagulant 4 days ago as instructed by his surgeon,
but has continued to take the multivitamin and vitamin E. An important collaborative problem or nursing diagnosis for this patient is which of the following?
1) Potential complication: anemia
2) Risk for infection related to inadequate anticoagulant dosage
3) Risk for noncompliance related to inability to follow instructions
4) Potential complication: increased bleeding
ANS: 4
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When talking with the family of a critical care patient, the nurse needs to
A) be gentle and indirect. B) have a futuristic approach. C) show interest and empathy. D) be distant and professional.
On the first postpartum day, the nurse teaches the client about breastfeeding. Two hours later, the client seems to remember very little of the teaching. The nurse understands this memory lapse to be due to:
1. The taking-hold phase. 2. Postpartum hemorrhage. 3. The taking-in phase. 4. Epidural anesthesia.
A client has been taught to inject insulin. Which statement made by the client indicates a need for further teaching?
a. "The abdominal site is best because it is closest to the pancreas." b. "I can reach my thigh the best, so I will use different areas of the same thigh." c. "By rotating the sites in one area, my chance of having a reaction is decreased." d. "Changing injection sites from the thigh to the arm will change absorption rates."
The nurse is caring for an adolescent who experienced trauma to the spleen that requires its removal
When discussing the proposed surgery with the patient's parents, the nurse would provide which information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The spleen is located in the left upper abdominal quadrant. 2. The spleen is involved in the return of bile to the liver. 3. The spleen has a minimal vascular system. 4. The spleen acts as a blood filtration system. 5. The spleen destroys aged red blood cells.