A client who has returned to the unit after arterial revascularization states that pain similar to that before the procedure is felt in the affected limb. What would be the nurse's best action?
A. Notify the surgeon.
B. Elevate the extremity.
C. Administer pain medication.
D. Place a warm blanket on the operative limb.
A
The surgeon should be notified if the client has an increase in ischemic pain because this signals graft occlusion.
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A possible goal for a client with a hearing impairment would be, "The client will participate in conversations and other social situations." Which nursing intervention is MOST appropriate to attain this goal?
a. consulting social services as needed b. identifying hospital and community resources for people who are hearing impaired c. speaking slowly and distinctly, giving the client time to respond d. using written materials whenever possible to communicate information
The 70-year-old client with terminal lung cancer tells the nurse, "I am dying because I sinned by smoking cigarettes.". What is the nurse's best response to this dying client?
1. "You are correct, but it is too late to do anything about it now.". 2. "When you started smoking cigarettes, we didn't know about the problems they cause. It is not your fault.". 3. "Why don't we call the hospital chaplain and you can pray about your sins?" 4. "Smoking cigarettes isn't a sin. There are many worse habits you could have.".
The ICU nurse is caring for a trauma victim whose status is critical. On assessment, the nurse notes uremic frost along the patient's hairline. What would this indicate to the nurse?
A) Renal failure B) Cardiovascular failure C) Hepatic failure D) Respiratory failure
What specific points would you include regarding managing insulin therapy? Select all that apply
a. Store unused insulin in the freezer. b. The insulin can be used if it is yellow but not expired. c. Administer the lispro (Humalog) within 15 minutes of eating. d. Ideally, the glargine (Lantus) should be administered at bedtime. e. Always administer the injections in the same, easy-to-reach location. f. The current vial of lispro (Humalog) can be kept at room temperature for 1 month. g. Two injections will be needed to administer lispro (Humalog) and glargine (Lantus).