The patient, age 91, has COPD and complains of dyspnea and fatigue. Activity intolerance, related to an imbalance between the oxygen supply and demand, is a nursing diagnosis for COPD. Which nursing intervention would be inappropriate?
a. Teach pursed-lip breathing.
b. Provide oxygen therapy as ordered.
c. Plan care to provide optimum rest.
d. Provide a cool shower.
C
Nursing interventions will be directed at attempting to decrease the patient's anxiety and promote optimal air exchange. The nurse should allow sufficient rest periods and should assist the patient in activities of daily living.
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The nurse is instructing a client recovering from pacemaker insertion surgery on signs that the pacemaker might not be functioning correctly. What should the client be instructed to report?
1. Weight gain of 5 pounds 2. Activity tolerance 3. Dizziness 4. Diarrhea
A child who has ß-thalassemia is receiving numerous blood transfusions. The child also is receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child
The nurse explains that the deferoxamine (Desferal) is given to: 1. Prevent blood transfusion reactions. 2. Stimulate red blood cell production. 3. Provide vitamin supplement. 4. Prevent iron overload.
The nurse is observing a patient administer insulin. Which observation indicates the need for further instruction? (Select all that apply.)
a. The patient uses a 90-degree angle to ad-minister the injection. b. The patient cleans the injection site with alcohol before the injection. c. The patient rubs the injection site after administration of the insulin injection. d. The patient draws up the cloudy insulin and then the clear insulin. e. The patient shakes the insulin bottle before administration.
In order to decrease fall risk due to orthostatic hypotension, what advice should be given to an older adult who is taking medication for hypertension?
a. Ambulate with a walker. b. Avoid hot baths. c. Avoid climbing stairs. d. Sit on the side of the bed for a moment before ambulation.