The nurse's priority assessment for a patient taking an antidepressant medication is for the presence of
a. suicidal ideation.
b. antiadrenergic side effects.
c. anticholinergic side effects.
d. symptoms of sexual dysfunction.
A
Antidepressant medication tends to energize depressed patients, possibly giving them the impetus to act on suicidal ideation that has been present related to the depression. This complication is particularly applicable to adolescents. Some suggest that suicidal ideation might be the actual result of antidepressant therapy. In either case the implication for nursing is clear: patients should be carefully assessed for the presence of suicidal ideation, suicidal plans, and means for carrying out the plans. This option is related to patient safety and takes priority over the other options.
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The nurse addressing gender identity issues instructs the client that there are gradations called transgender. Which of the following teaching would include information on transgender biologic gradations? Standard Text: Select all that apply
1. Abnormal gender 2. No gender 3. Unclear gender 4. Blending of gender 5. Clear gender
When the nurse cautions a patient to watch his step, the nurse assesses evidence of concrete thinking when the patient:
a. fixedly begins to watch his feet. b. immediately examines his watch. c. begins to watch the nurse's feet. d. stands rigidly in one place without moving.
A 28-year-old woman is scheduled for a glucose tolerance test. She asks the nurse what results indicate gestational diabetes
The nurse should respond that the minimum parameter for indication of gestational diabetes is a 2-hour blood glucose level greater than: A) 120 mg/dL B) 150 mg/dL C) 200 mg/dL D) 250 mg/dL
Which statement best explains the importance of electronic medical record use?
1. It takes less time for nurses to document. 2. Patient care is improved. 3. Access to the record is limited to nurses, so no other disciplines' charting gets priority. 4. Passwords are permanent, therefore lost passwords are not an issue.