The emergency department nurse palpates a patient's skin to assess its texture. The nurse manager would evaluate that this nurse is following protocol if which technique is used?
1. The nurse palpates the skin with the dorsal surface of the hand.
2. The nurse palpates the skin with the palmar surface of the fingers and finger pads.
3. The nurse places the palm of the hand on the patient's skin.
4. The nurse touches the skin with the anterior surface of the wrist.
2
Rationale 1: The dorsal surface of the hand will reveal information about moisture, but not texture.
Rationale 2: The palmar surface of the fingers and finger pads should be used to assess the skin's texture.
Rationale 3: The palm of the hand does not have as many nerve endings and is not as sensitive to changes in texture as another part of the hand.
Rationale 4: The anterior surface of the wrist does not have discriminatory nerve endings that would provide information about texture.
You might also like to view...
A nurse assigns a client the nursing diagnosis of complicated grieving. According to Bowlby, which long-term outcome would be most appropriate for this nursing diagnosis?
1. The client will accomplish the recovery stage of grief by year one. 2. The client will accomplish the acceptance stage of grief by year one. 3. The client will accomplish the reorganization stage of grief by year one. 4. The client will accomplish the emotional relocation stage of grief by year one.
You are caring for a client who is 42 years old and status post adenoidectomy. You find the client in respiratory distress when you enter his room. You ask another nurse to call the physician and bring an endotracheal tube into the room
What do you suspect? A) Infection B) Postoperative bleeding C) Edema of the upper airway D) Plugged tracheostomy tube
One key difference between research and evaluation is the ability of the researcher to:
a. control all extraneous variables. b. generalize the results to a larger population. c. predict the outcome based on probability factors. d. remain objective during the research process.
What role should the nurse leader focus on when the emergency room is notified of a multi-vehicle
accident involving numerous injuries and ten of the injured individuals are expected to arrive in the emergency room within 30 minutes? A) Communicator B) Decision maker C) Negotiator D) Team builder