Select the statement by the nurse that is most accurate when instructing a client with a newly formed permanent colostomy on how to use the irrigation set to prevent constipation
a. Make sure the irrigation bag is above the level of your head for best results.
b. Insert the lubricated catheter 2 to 4 inches into the stoma.
c. Dilate the stoma prior to beginning the procedure by using one finger.
d. Use cold water to best stimulate colon pe-ristalsis.
B
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During a group session, a client becomes very angry at a comment by another member of the group. The therapist asks why the client became so angry. The group is using:
1. Events for emotional awareness. 2. Interpersonal conflict issues to resolve personal issues. 3. The self-reflective loop. 4. Fear.
In order to establish a meaningful relationship with the patient and family during a crisis, the critical care nurse must demonstrate
A) strong coping skills. B) an ability to help. C) a firm, unbiased opinion. D) a matter-of-fact attitude.
A patient is brought to the emergency department by her family after falling off the roof
A family member tells the nurse that when the patient fell she was "knocked out" but came to and "seemed okay." Now she is complaining of a severe headache and not feeling well. The nurse suspects an epidural hematoma. Based on the knowledge of the progression of this type of hematoma, the nurse prepares for which priority intervention? A) Insertion of an intracranial monitoring device B) Treatment with antihypertensives C) Emergency craniotomy D) Administration of anticoagulant therapy
The nurse shows an understanding of the psychological implications for a client on isolation when planning care to control the risk of:
A. Denial B. Aggression C. Regression D. Isolation