The client with a fever has dry, cracked lips and a sticky white coating on the tongue and oral mucous membranes. What is the nurse's best action?
A. Determine when the client last ingested dairy products.
B. Obtain a swab culture of the mucous membranes.
C. Document the observation as the only action.
D. Offer oral hygiene.
D
The presence of fever predisposes the client to dehydration. Manifestations of dehydration in-clude dry, cracked lips and a sticky white coating of oral mucous membranes. Providing oral care can increase the client's comfort and reduce the risk for an oral infection.
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A nurse is caring for a patient near the end of life whose wishes regarding care are not known. The two sons disagreed with the two daughters about future medical plans for the patient during a recent family conference,
and now the sons and daughters are not talking to one another. What action by the nurse would be best to help resolve this dilemma? A. Call the facility's ethics committee and request a formal consultation. B. Have social work coordinate another family meeting to discuss the issue. C. Meet with the sons and daughters separately to discuss their wishes. D. Request that the physician tell the family what is in the patient's best interests.
The nurse manager overhears health care providers make inaccurate comments about the sexuality of older patients. Which comment should the nurse correct or follow up with teaching?
A) "Overall, sex takes longer for older men than younger men.". B) "Older people are less sexually responsive than young people.". C) "Both men and women have orgasms less often than younger people do.". D) "Sexual intercourse is usually not physically possible for older women because vaginal lubricant production ceases with menopause.".
Autonomic dysreflexia affects persons:
a. In persistent vegetative states b. With hemiplegia c. With spinal cord injuries above the mid-thoracic level d. With ALS
The nurse is preparing to administer nitroglycerine via the intravenous route. What must the nurse plan to do prior to administering this medication?
1. Use gloves to prevent self-administration. 2. Instruct the patient to avoid moving the arm in which the medication is infusing. 3. Cover the intravenous (IV) bottle to decrease light exposure. 4. Darken the room to decrease light exposure.