The client with breast cancer has just been admitted after four radiation treatments. After completing the initial assessment, the nurse determines that which of the following is an important nursing diagnosis for this client?
1. Excess Fluid Volume
2. Activity Intolerance
3. Ineffective Breathing Pattern
4. Risk for Infection
4. Risk for Infection
Rationale:
Radiation causes skin excoriation. With the excoriation, the client is at risk for infection due to skin breakdown. The client who receives radiation is more at risk for fluid volume deficit. Depending on the assessment, the client may or may not have activity intolerance. There is no evidence of respiratory difficulties in this client.
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The nurse is discussing strategies for preventing sensory impairments with the parents of a newborn. Topics to include to protect hearing include:(Select all that apply) Standard Text: Select all that apply
1. Obtain regular immunizations 2. Seek medical attention for reduced eye contact 3. Keep auditory stimulation to a minimum 4. Have children wear ear protection in noisy environments 5. Have regular health examinations
A newborn has talipes and has been casted. The nurse explains that the casts must be changed:
a. daily. b. weekly. c. bi-weekly. d. monthly.
Which of the following best describes the documentation that the nurse should expect to complete during the home visit?
a. Creation of a carefully laid out nursing care plan for future visits b. Documentation of assessment data and care given demonstrating the nurse's effectiveness c. Necessary documentation will depend on the agency policies and forms d. Completed Medicare forms per the Health Care Financing Administration (HCFA) regulations for reimbursement
If a researcher studying family response to adolescent suicide interviewed parents and siblings independently, the triangulation approach method would be called which of the following?
A) Data triangulation B) Investigator triangulation C) Theory triangulation D) Method triangulation