A client with disseminated intravascular coagulation (DIC) has a nursing diagnosis of Impaired Gas Exchange. Which action is inappropriate when providing care based on this nursing diagnosis?
A) Place client in low-Fowler position to improve gas exchange.
B) Monitor the client's oxygen saturation continuously.
C) Maintain bed rest.
D) Encourage deep breathing and coughing.
Answer: A
Micro clots in the pulmonary vasculature are likely to interfere with gas exchange in the client with DIC. The nurse should place the client in Fowler or high-Fowler position to improve gas exchange. Monitoring the client's oxygen saturation continuously, maintaining bed rest, and encouraging deep breathing and coughing are all interventions the nurse should implement.
You might also like to view...
If solely for this reason, Medicare will not cover home health aide visits. What is that reason?
a. Physical assistance b. Physician orders c. Personal care d. Household chores
A client has been admitted to the health care facility and a plan of nursing care has been created
The nursing care plan specifies that client education should begin as soon as possible and a nurse has begun an assessment in preparation for this education. What assessment parameter should the nurse prioritize during this assessment? A) The client's occupation B) The client's social support network C) The client's motivation D) The client's coping skills
The nurse is caring for a patient with schizophrenia who is admitted to the hospital after being found incoherent and combative at a local grocery store. The patient tells the nurse that he has not taken his medications for over two weeks
The nurse is assessing the patient's needs, symptoms, and strengths. What stage of the nurse-patient relationship is being demonstrated? 1. Working 2. Orientation 3. Identification 4. Pre-orientation
The nurse is aware that thyroid hormone production is dependent on the intake of:
a. protein and iodine. b. fats and vitamins. c. carbohydrates and minerals. d. sodium and potassium.