As D.H.'s primary nurse, you are responsible for his nursing care plan. In addition to his risk for increased
intracranial pressure, you determine you are concerned about managing pain and avoiding seizure
related injury.
You decide to address each of these areas in his plan of care.
You plan to administer prescribed as-needed analgesics. What are three other strategies that
will facilitate the expected outcome of managing his acute pain?
• Use nonpharmacologic interventions such as a cool cloth, deep breathing, and guided imagery.
• Minimize environmental stimuli (e.g., provide a quiet environment, limit number of visitors and
their length of stay, close curtains, dim lights).
• Avoid jarring the bed or startling him.
• Encourage sleep and provide uninterrupted periods of rest.
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Which of the following nursing diagnoses would the nurse anticipate for a family who has a child with acquired immune deficiency syndrome (AIDS)?
1. Anticipatory Grieving 2. Compromised Family Coping 3. Impaired Parenting, risk for 4. Parental Role Conflict
What should be the most significant assessment when gathering data concerning the muscu-loskeletal system?
a. Slow gait b. Degree of motion of all joints c. Enlarged joints d. Crepitus in joints
A family member of a client receiving dobutamine intravenously asks the nurse how that will help their blood pressure. Which response should the nurse provide?
A. "The prescription is a vasopressor and helps the heart beat more effectively, which will increase blood pressure." B. "Vasopressor drugs act on the renin-angiotensin system which will increase the blood pressure." C. "The prescription is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller." D. "The prescription is a vasopressor which will help increase blood flow to peripheral muscles."
A Muslim woman and her husband are seen in the health care clinic because the woman suspects that she is pregnant. When planning for the physical assessment of the woman, which should the nurse ensure?
A. A female health care provider examines the woman B. The woman's husband remains in the examining room at all times C. The woman is examined without any other people in the examining room D. Written permission is obtained from the woman to obtain subjective health data