A patient has been diagnosed with a balance disorder that is expected to clear on its own in a few weeks

Which safety information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "Use a stepladder to get things off high shelves instead of reaching up over your head.".
2. "Don't pick up objects from the floor.".
3. "Do not drink alcohol until your condition passes.".
4. "Have someone put nonslip surfaces in the floor of your shower.".
5. "Be certain to drink enough fluids while you are sick.".


3,4,5
Rationale 1: This patient should not climb a stepladder.
Rationale 2: This statement is unrealistic in that picking up objects from the floor, such as shoes or clothing, is part of everyday life. The nurse should teach the patient a method of picking up these objects safely, such as using an assistive device.
Rationale 3: Alcohol can cause vertigo and should be avoided.
Rationale 4: The patient is at risk for falls, and nonslip surfaces can make slick surfaces such as the shower floor less of a hazard.
Rationale 5: Dehydration can cause vertigo, so the patient should stay well hydrated.

Nursing

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A nurse documents the following assessment on an older adult client's chart: "dry, thin skin." Which of the following nursing diagnoses would be appropriate for this client?

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A patient who has had abdominal surgery has been receiving morphine sulfate via a patient-controlled analgesia (PCA) pump

The nurse assesses the patient and notes that the patient's pupils are dilated and that the patient is drowsy and lethargic. The patient's heart rate is 84 beats per minute, the respiratory rate is 10 breaths per minute, and the blood pressure is 90/50 mm Hg. What will the nurse do? a. Discuss possible opiate dependence with the patient's provider. b. Encourage the patient to turn over and cough and take deep breaths. c. Note the effectiveness of the analgesia in the patient's chart. d. Prepare to administer naloxone and possibly ventilatory support.

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A nurse's identification badge includes the wording, 'Psychiatric Mental Health Nurse'. A client with a history of paranoia asks, "What does that title mean?" The nurse responds best when answering:

a. "Don't be afraid, it means I'm here to help not hurt you." b. "Psychiatric Mental Health nurses care for people with mental illnesses." c. "We have the specialized skills needed to care for those with mental illnesses." d. "The nurses who work in mental health facilities have that title."

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