The nurse suspects that a client has developed phlebitis from an intravenous catheter when which of the following is assessed? (Select all that apply.)
1. Redness
2. Cool skin over the intravenous site
3. Warmth over the intravenous site
4. Elevated body temperature
5. Hard palpable cord along the vein track
6. Blanching of the skin
1, 3, 4, 5
Evidence of phlebitis from an intravenous catheter includes redness, warmth over the intravenous site, pain, elevated body temperature, and a hard palpable cord along the vein track. Cool skin over the intravenous site and blanching of the skin are assessment findings for an infiltration.
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The estranged husband of a patient is seen picking up and reading the patient's medical record. The patient later asks the nurse how her husband learned about her health status. Which of the following should the nurse do?
1. Report this violation to the hospital administration. 2. Tell the patient that she has no idea how he learned of her health status. 3. Nothing. 4. Ask the patient how she knows that her husband is aware of her health status.
Kaylee is 6 years old. She will require hospitalization for correction of a bowel obstruction. She could be hospitalized in a(n):
a. Pediatric hospital b. A general hospital that admits children c. The pediatric unit of a general hospital d. All of the above
A patient receives halothane for anesthesia and large doses of epinephrine for the control of bleeding. Select the best nursing diagnosis
1. Risk for decreased cardiac output related to dysrhythmias secondary to sensitization of the heart from catecholamines 2. Risk for impaired thermoregulation related to malignant hyperthermia secondary to ambient temperature in the operating room 3. Risk for violence related to decreased hepatic metabolism of both drugs resulting from deranged hepatic blood flow 4. Risk for ineffective breathing pattern related to prolonged respiratory depression resulting from decreased expiration of the volatile gas
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What will be an ideal response?