Which scenarios contribute to effective handoff communication at change of shift? (Select all that apply.)
a. The nephrology consultant physician is making rounds and asks you to update her on the patient's status and assist in placing a central line for hemodialysis.
b. The noise level is high because twice as many staff members are present and everyone is giving report in the nurse's station.
c. The unit has decided to use a standardized checklist/tool for change-of-shift reports and patient transfers.
d. You and the oncoming nurse conduct a standardized report at the patient's bedside and review key assessment findings.
C, D
A reporting tool and bedside report improve handoff communication by ensuring standardized communication and review of assessment findings. Conducting report at the bedside also reduces noise that commonly occurs at the nurse's station during a change of shift. The nephrologist has created an interruption that can impede handoff with the next nurse. Likewise, noise in the nurse's station can cause distractions that can impair concentration and listening.
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Dyspnea with wheezing, a nonproductive cough, and pulmonary crackles that progress to the gurgling sounds of pulmonary edema is described as
a. dyspnea. c. paroxysmal nocturnal dyspnea. b. orthopnea. d. cardiac asthma.
The patient with diabetes is also taking ephedrine to treat asthma that causes her blood sugar to increase. The patient asks the nurse, "Why does this medication make my blood sugar go up?" What is the nurse's best response?
A) "The active ingredient in ephedrine is mixed with sugar." B) "Ephedrine is a placebo containing only sugar." C) "Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels." D) "Insulin is inactivated by ephedrine so it cannot work to control sugar levels."
A nurse is observing another nurse prepare insulin for administration to a diabetic patient. Which observation is considered unsafe?
a. The nurse draws up the Regular insulin first, then the NPH insulin. b. The nurse draws up both the Regular and NPH insulin in the same syringe. c. The nurse draws up the insulin in a syringe calibrated in milligrams (mg). d. The nurse draws up 30 units of NPH insulin as ordered by the physician.
A patient recovering from a broken leg asks why the pain is so sharp. What should the nurse explain about acute pain?
Select all that apply. 1. The pain signal releases catecholamines. 2. The pain signal reduces blood flow to the gut. 3. The pain signal travels along nerve fibers to the spinal cord. 4. The pain signal travels up to the brain portion called the thalamus. 5. The pain signal spreads throughout the cortex, limbic system, and brainstem