Which of the following signs would alert the nurse to possible nutritional alterations? (Select all that apply.)
a. Impaired wound healing
b. Edema
c. Nail growth
d. Muscle atrophy
e. diaphoresis
A, B, D
Impaired wound healing, edema, and muscle wasting atrophy are indicative of impaired nutrition. Nail growth would indicate normal caloric intake. Diaphoresis refers to sweating and is indicated with exercising and infection.
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A patient in labor has internal fetal monitoring and normal vital signs. All fetal signs are reassuring. She wishes to try whirlpool bath hydrotherapy as a comfort measure. Which action by the nurse is best?
A. Assist the woman into the tub so she doesn't fall. B. Ensure the water temperature does not exceed 101 °F (38.3 °C). C. Inform her that she is not able to participate in this method. D. Remove the fetal monitor wires prior to the patient's getting in the tub.
An adult patient with a history of severe lower back pain has sought care because of a recent exacerbation of his health problem that has been unrelieved by a visit to his chiropractor
The patient states that he has heard conflicting advice on exercise and activity during periods of back pain. What activity management strategy should the clinic nurse recommend to this patient? A) Bed rest for several days, if possible B) Maintaining or immediately increasing activity levels C) Resting for a day or two and then gradually increasing activity D) Alternating periods of activity and rest until relief is obtained
Management of a client with a stage III ulceration would include which of the following? (Select all that apply.)
a. frequently assessing lung sounds b. frequently changing position c. air-filled mattress d. debridement of the wound bed e. encouraging intake of foods high in vitamin C and protein
Which of the following instructions given by the nurse to the client would help promote urinary elimination?
A) "Urine color changes are not important." B) "Don't interrupt your day by going to the bathroom; wait until you're at a good stopping place." C) "Drink 8–10 glasses of water daily." D) "Wash with soap and water every other day."