You are assuming care of a 16-year-old patient who is in skeletal traction following a motor vehicle accident. You take shift report and find out that the patient avoids using the urinal and bedpan because they "embarrass him."
When you assess the patient you find that the patient's temperature is 101.5°F and his blood pressure and pulse are elevated. What would the nurse suspect?
A) Sacral skin breakdown
B) Infected pin sites
C) Urinary infection
D) Urinary incontinence
Ans: C
Feedback: Incomplete emptying of the bladder related to positioning in bed can result in urinary stasis and infection.
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When administering a topical antifungal via the vaginal route, what action would the nurse take?
A) Place the patient in left lateral Sims' position. B) Applied using sterile technique C) Administered high into the vagina. D) Insert a tampon after insertion.
The nurse admits a patient to the emergency department and recognizes the patient is in diabetic ketoacidosis (DKA) when what manifestations are assessed? (Select all that apply.)
A) Fruity breath B) Edema C) Dehydration D) Agitation E) slow and deep respirations
The nurse is performing an assessment of an 82-year-old patient's eyes. Which patient statements should the nurse expect based on the patient's age?
Select all that apply. 1. "I've been having some drainage from the inside corner of my eye." 2. "My eyes feel so dry most of the time." 3. "I have almost fallen several times at home going down our basement stairs." 4. "I have this white circle around the color of my eyes." 5. "I have a hard time driving at night."
Which statement is correct about childhood obesity?
a. Heredity is an important factor in the development of obesity. b. Childhood obesity in the United States is decreasing. c. Childhood obesity is the result of inactivity. d. Childhood obesity can be attributed to an underlying disease in most cases.