You are writing a care plan for a patient with a nasogastric tube. What would be a major nursing diagnosis for this patient?
A) Risk of infection related to tube feedings
B) Risk for impaired skin integrity due to reflux of gastric contents
C) Improved body image related to presence of tube
D) Acute pain
Ans: D
Feedback: Based on the assessment data, the major nursing diagnoses in the postoperative period may include the following: Acute pain; Risk for infection related to presence of wound and tube; Risk for impaired skin integrity at tube insertion site; and Disturbed body image related to presence of tube.
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Which of the following statements about spirituality is TRUE?
a. There is no evidence of a connection between spirituality and health. b. Spiritual nursing requires specialized training in order to perform. c. Spirituality and values are the same. d. Spirituality is the core of a person's being.
A patient with angina is beginning nitroglycerin. Before administering the drug, the nurse informs the patient that, immediately after administration, the patient may experience what?
A) Nervousness or paresthesia B) Throbbing headache or dizziness C) Drowsiness or blurred vision D) Tinnitus or diplopia
Which ostomy will have the most formed drainage? The ostomy located in the
a. ileum c. transverse colon b. ascending colon d. descending colon
The nurse is concerned that a patient's intracranial pressure monitor readings are incorrect
What can the nurse do to ensure that the monitor is measuring accurately? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Check the location of the stopcocks. 2. Check the position of the transducer. 3. Check the monitoring line for air. 4. Ensure the catheter is not obstructed. 5. Check to make sure the dressing is dry.