The nurse is caring for an older adult who has dementia. The patient has just returned from recovery after a percutaneous endoscopic gastrostomy (PEG) tube placement. Which interven-tion(s) should the nurse implement? (Select all that apply.)
a. Place IV tubing behind the patient.
b. Hang the IV bag behind the patient's field of vision.
c. Cover the PEG tube with an abdominal binder.
d. Use wrist restraints.
A, B, C
Placing the tube behind the patient, hanging the IV bag behind patient's field of vision, and cov-ering PEG tube with an abdominal binder decrease the likelihood of the patient accidently pull-ing out the lines. Soft mitts should be used instead of hand restraints.
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A client seeking treatment for severe knee pain has worked in a factory for 30 years in a position requiring repetitive lifting and carrying of 20-40-pound boxes. The nurse anticipates which recommendation from the multidisciplinary team?
A) Joint replacement surgery B) Pharmacologic therapy C) Refer for Disability application. D) Intermittent use of a cane
An amputation of a gangrenous limb that is left open for 10 days before closure is classified as a(n) _____ amputation
Fill in the blank(s) with correct word
The nurse is caring for several clients who sustained chemical injuries. Which statement related to chemical injuries does the nurse understand to be true? Select all that apply.
A) The potential for unintentional exposure should be assumed, even if not apparent. B) A priority intervention is the removal of clothing. C) Protection of caregivers from exposure is important while caring for clients with these injuries. D) The injury-inducing agent may be difficult to identify without specialized equipment. E) Decontamination should occur with copious of amounts of soap-free water.
The nurse has administered adenosine (Adenocard). What is the expected therapeutic response?
a. Increased intraocular pressure b. A brief tonic-clonic seizure c. A short period of asystole d. Hypertensive crisis