3% of all residents had some kind of advance directive (SOURCE: National Nursing Home. Monitor for continence and urinary retention when the catheter is removed. Which statement by the client indicates that teaching was effective? I may need to restrict my activities for several months. Maintain the client in a prone position. A clear understanding by the client and family of the purpose, anticipated benefits, and consequences of total laryngec-tomy prior to surgery is vital to promote postoperative recovery. onset to be at 4 p. 2 F, SaO2 89% on RA. Nursing Care Plans. If oxytocin is ordered postoperatively for the client who has had a cesarean birth, the most important nursing intervention would be to: A. Describe the nursing care of a patient with a total hip arthroplasty. The nurse reviews with the client a routine discharge teaching plan concerning postoperative care. 8 mEq/L; and Client D, scheduled for an appendectomy who has a white blood cell count of 15,000 mm3. 7,16,17 Patients who develop delirium stay in the hospital 2 to 5 days longer than similar patients without delirium and have a 3-fold increased risk of requiring institutional. 3) Change the litter boxes while wearing gloves. Although postoperative care units are mostly managed by a team of both anesthesiologists and surgeons or only by anesthesiologists in Europe and Japan, surgeons' presence and co-leadership is of great importance in postoperative care. The affected leg is warm. What intervention should. The client tells the nurse he is calling his family to come pick him up. Correct response: Notify the physician. The nurse is assigned to care for a client who had a myocardial infarction (MI) 2 days ago. It often results from excess body weight and physical inactivity. A therapeutic nurse-client relationship that facilitates communication D. ATI Pharmacology – Proctored Assesment Latest 2020 Graded A A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0. The client refuses breakfast B. Elevate the foot of the bed. 3) Change the litter boxes while wearing gloves. Driving may be resumed a couple weeks after that if off opioid medications. B) Assist in moving to prevent strain on the suture line. POSTOPERATIVE CARE •Provide routine postoperative care as outlined in Chapter 7. General postoperative care recommendations include: • Skin grafts placed on your arm or leg: Raise the arm or leg above the level of your heart for much of the day and night. When a surgeon must perform an anastomosis, care is taken at every step of the way. Prioritize the patient's desired dietary progression. Once the surgeon is satisfied that the join is complete, it is tested to confirm that it does not leak, and then the surgical site is closed so the patient can be brought out of anesthesia. Recent data suggest 80 percent of patients experience pain postoperatively 2 with between 11 and 20 percent experiencing severe pain. client's ability to assist with postoperative care procedures. The nurse knows that incontinence causes skin breakdown through maceration of A nurse is caring for a patient who has a large wound on his ankle. Give acetaminophen to control the child’s fever B. wound infection. Which of the following items should the nurse tell the client he may now request to have on his meal tray? A. A nurse is caring for a client who has hypovolemic shock. Which of the following oxygen delivery systems should the nurse initiate to provide the highest concentration of oxygen?. an accredited program to care for clients with d. From 1998 to 2001, for instance, the number of malpractice payments made by nurses increased from 253 to 413 (see Figure 1, page 55). A postpartum client overhears the nurse tell the health care provider that she has a positive Homans sign and asks what it means. pdf), Text File (. Which of the following findings is the best indicator of the medication's effectiveness: 1) Urine output 50 mL/hr. That nurse was Florence Nightingale, defining the art of nursing in the 1850s. Client who is crying and agitated b. NR 305 Hesi questions and answers (Fall 2018) - Chamberlain College (A grade) HESI QUESTIONS 1. It is acceptable for the nurses to talk about a client because they are on the same treatment team. Some clients do not appear to be bothered by their confusion. Nursing Care Plan for Cesarean Section (C-section) - These days we want to discuss the article with the title health Nursing Care Plan for Cesarean Section (C-section) we hope you get what you're looking for. In planning nursing care, the nurse would incorporate which of the following as the best strategy to assist the client in coping with the disease? 1. Which of the following nursing interventions is an indirect-care intervention? 1) Emotional support 2) Teaching 3) Consulting 4) Physical care ANS: 3 An indirect-care intervention is an activity performed away from the client on behalf of the. The nurse is aware that the best way to prevent postoperative wound infection in the surgical client is to: A. The 18 year old with a fracture to two cervical vertebrae b. ATI Pharmacology – Proctored Assesment Latest 2020 Graded A A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0. A client is complaining of severe flank and abdominal pain. This article, the first in a two-part series, identifies the principles of postoperative nursing care. Question: The nurse is caring for four clients: Client A, who has emphysema and whose oxygen saturation is 94%; Client B, with a postoperative hemoglobin of 8. Monitor for continence and urinary retention when the catheter is removed. Monitor the client's cardiac status (Peds p120) c. A client prescribed an anticoagulant who has missed several doses is at risk for thrombosis; therefore, the nurse should check the client’s last INR to determine the client’s coagulation status. what information should the nurse include. apple juice C. What action should the nurse implement? HESI. NR 324 Adult Health 1 Study Guide (2019-20 Miles) A nurse is caring for a client who requires a 24-hr urine collection. Postoperative care is the care you receive after a surgical procedure. Your wound does not stop bleeding even after you apply firm pressure for 15 minutes. •M bor owtleoni sounds and degree of abdominal distention. Nursing Care Plan for Cesarean Section (C-section) - These days we want to discuss the article with the title health Nursing Care Plan for Cesarean Section (C-section) we hope you get what you're looking for. #N#The nurse is caring for a client with a right ankle sprain. The nurse should also ask the UAP to report client concerns after completing the task but the UAP cannot assess the client; only nurses can assess, plan and evaluate client care. ureru•Msae ine output every 30. Communication will come from the testing location if the exam is cancelled or the exam date changes. The nurse obtains subjective and objective data in a number of ways: talking to clients, observing clients and/or significant others, taking a health history, performing a physical examination, evaluating lab results, and collaborating with other members of the health care team. A client who is scheduled for an ileostomy surgery and been taking corticosteroids is instructed to taper the drug, eventually discontinuing it. Which of the following interventions should the nurse include in the plan of care? a. The bridge NURSING CARE OF THE CLIENT WITH A COLOSTOMY •Assess the location of the stoma and the type of colostomy per-formed. docx), PDF File (. The client’s blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. Check client's INR Information on health care law to a group of newly licensed nurses. Expiratory rales Atorvastatin prescription Peripheral vascular disease Potassium level of 3. Provide stimulation. Which of the following actions should the nurse take first? A- Notify the provider. A nurse is providing skin care to a client who has been incontinent in her bed. Client with a verbal pain report of 9 ANS: C. Question 2 See full question. A nurse is caring for a client with tuberculosis who is fearful of the disease and anxious about the prognosis. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL 2) Total t4 level is 2 mcg/dL A. Which of the following foods should the nurse provide at the initial feeding? Vanilla pudding Apple juice Diet ginger ale Clear liquids. hyponatremia. Which of the following is an appropriate nursing intervention for the client at this time? 1. What action should the nurse implement? HESI. Provide stimulation. A nurse in the health care provider's office is measuring vital signs on a postoperative client who underwent mastectomy of her right breast 2 weeks ago. Which of the following interventions should the nurse include in the plan of care? a. Which client should the nurse assess first? 1. A client prescribed an anticoagulant who has missed several doses is at risk for thrombosis; therefore, the nurse should check the client's last INR to determine the client's coagulation status. wrap each wrist with gauze dressing beneath the restraints c. NR 324 Adult Health 1 Study Guide (2019-20 Miles) A nurse is caring for a client who requires a 24-hr urine collection. I flushed what I urinated at 7. Assess a 12 lead ECG immediately on anyone complaining of chest pain to determine if an ST elevated MI is occurring. Intensive monitoring in the critical care unit is required. Follow the weaning protocol per orders. an accredited program to care for clients with d. txt) or read online for free. The client who is 1 day postoperative for total hip replacement (THR) who has. Ibuprofen (Advil) is prescribed for a client. There is some data that the epidural route may provide better pain relief, but there is no clear difference in time to recovery of physical independence in older patients. its a presentation of question and answers regarding pediatric nursing. which of the following clinical manifestations indicate. Give acetaminophen to control the child’s fever B. 25,26 Significant, often prolonged episodes of hypoxemia are common in hospitalized patients in the 48 hours after surgery and are frequently. Final evolve exam. Today's top 24 Homecare jobs in Anthony, New Mexico, United States. The nurse suspects a wound infection because the drainage on the dressing is yellow and thick. They may respond in a physical, behavioral, or functional manner. Epidemiology • Hip fracture is a major health problem as population ages • HK (1995): 11/1000 in women, 5/1000 in men >70yrs (Lau et al, 1999). To assess for pneumothorax resolution, the nurse can anticipate that the client will require: You Selected: a chest X-ray. Which of the following foods should the nurse provide at the initial feeding? A. While transferring to a chair, the client cries out in pain. A) Malignant hyperthermia. The client refuses breakfast B. Which observation should alert the nurse to call the Rapid Response Team (RRT)? 75. 7 mg/dl; Client C, newly admitted with a potassium level of 3. A client is complaining of severe flank and abdominal pain. ATI Med-Surg 1. The client who is on contact isolation for methicillin-resistant Staphylococcus aureus (MRSA) 2. I flushed what I urinated at 7. a nurse in an ED is caring or a client who has advanced lung cancer. Inform the client that he should be voiding 150 to 200 mL of clear yellow urine every 3 to 4 hours by 3 days after surgery. O Remove one restraint at a time. What action by the nurse is best?. How should the nurse best determine the correct length of the nasogastric tube? A) Place distal tip to nose, then ear tip and end of xiphoid process. The UAP applies wrist restraints on the 7-month-old who is 1 day postoperative cleft palate repair. client who has not had a bowel movement in 4 days abdomen is firm b. During the postoperative period, reestablishing the patient's physiologic balance, pain management. com is the #1 online resource for nursing assessment, diagnosis, planning, implementation and evaluation. Nearly one-half (48. Client with a heart rate of 104 beats/min c. You are caring for clients in a long term care facility. The nurse is caring for the 30-weeks-pregnant client who is having contractions every 11 /2 to 2 minutes with spontaneous rupture of membranes 2 hours ago. ID: 311038812 The nurse is teaching a client about precautions for a new prescription for lovastatin (Mevacor). 76, no person acting in good faith who participates in the review or evaluation of the services of health care providers or facilities or the charges for such services conducted in connection with any program organized and operated to help improve the quality of health care, to avoid improper utilization of the services of health care providers or. Inform the client that he may pass small clots and tissue debris for several days. I flushed what I urinated at 7. I will expect to have moderately severe pain for 1-2 days C. A nurse is assessing a 4-year-old child who is 2 days postoperative following insertion of a ventriculoperitoneal shunt. How should the nurse best determine the correct length of the nasogastric tube? A) Place distal tip to nose, then ear tip and end of xiphoid process. The nurse is changing the dressing of a client who is 4 days postoperative with an abdominal wound. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits&sol. The nurse develops a postoperative plan of care for the client and should include which intervention in the plan? 1. a nurse is caring for a client who is 2 days postoperative following bowel resection and reports sudden severe abdominal pain. A nurse is caring for a client who has stage 4 lung cancer and is 3 days postoperative following a wedge resection. A nurse is caring for a postoperative client on the surgical unit. Give acetaminophen to control the child’s fever B. 4. Follow the weaning protocol per orders. Chapter 36 Comprehensive Examination 1 Review Questions: Part A 1. and its peak at 6 p. This nursing care plan for vomiting includes a diagnosis and care plan for nurses with nursing interventions and outcomes for the following conditions: Risk for Fluid Volume Deficient & Acute Pain. nursing care post op Laparotomy. The nurse is working with postoperative clients on a surgical unit. This includes care given during the immediate postoperative period, both in the operating room and postanesthesia care unit (PACU), as well as during the days following surgery. Our community brings together students, educators, and subject enthusiasts in an online study community. The nurse identifies this type of drainage as. You are caring for clients in a long term care facility. Teach the client to avoid heavy lifting, stressful exercise, driving, Valsalva's maneuver, and sexual intercourse for 2 to 6 weeks to prevent strain, and to call the physician if bleeding occurs or there is a decreased in urinary stream. 8 mEq/L; and Client D, scheduled for an appendectomy who has a white blood cell count of 15,000 mm3. A postoperative client receives a dinner tray with gelatin, pudding, and vanilla ice cream. The nurse would instruct the woman to notify her health care provider if she develops which of the following? A. 1) You are caring for a cirrhotic client with jaundice. A nurse is caring for a client who is 3 days postoperative following a right total hip arthroplasty. Nurse April is caring for a client who underwent a lumbar laminectomy 2 days ago. Which assessment finding is the best indicator that the client does not need pain medication at this time? a. A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. The nurse suspects a wound infection because the drainage on the dressing is yellow and thick. com Blogger 54 1 25 tag:blogger. Pallor and coolness of the affected When planning the client’s care, the leg nurse should give. I had a bowel movement, but I was able to save the urine. Which is a priority intervention? a. What action by the nurse is best?. A nurse is caring for a patient who is 2 days postoperative after abdominal surgery. Today, the nurse notes increased serosanguinous drainage, wound edges not approximated, and a ¼-inch gap at the lower end of the incision. NURS 3247 ATI Pharmacology – Proctored Assessment (Spring 2020) ATI Pharmacology – Proctored Review A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0. Follow the weaning protocol per orders. monitors for signs of fat embolism, 6 F (37. Search 22 Client Support jobs now available in Listowel, ON on Indeed. and the nurse notes redness and edema. A closed drainage system mini-mizes the risk for urinary tract infection. The client usually has a restriction of food and fluids for 6 to 8 hours before surgery instead of 24 hours. The nurse is assessing a patient's right knee, and the assessment reveals edema, tenderness, muscle spasms, and ecchymosis. The nurse obtains the postoperative assessments, the nurse following assessment findings: T= 00. Pneumonia can be community acquired or hospital acquired. 2 g/dL and hematocrit of 36. The nurse notes that bowel sounds are present. Laparotomy is the surgical removal of the colon due to intestinal adhesions and usually occurs in the small intestine. Citation: Liddle C (2013) Postoperative care 1: principles of monitoring postoperative patients. 60 minutes before breakfast d. Free, fast and easy way find a job of 25. Which of the following instructions should the nurse include in the teaching? 1) Take temperature once a day. A client taking risperidone 2 mg orally twice a day informs the nurse that she will be getting married in 3 months to another client she met at the outpatient clinic. The nurse knows that incontinence causes skin breakdown through maceration of A nurse is caring for a patient who has a large wound on his ankle. - A nurse is providing care for a client who is 2 days postoperative following abdominal surgery and is about to progress from a clear liquid diet to full liquids. NR 305 Hesi questions and answers (Fall 2018) - Chamberlain College (A grade) HESI QUESTIONS 1. Which of the following actions should the nurse take first? A- Notify the provider. The nurse obtains subjective and objective data in a number of ways: talking to clients, observing clients and/or significant others, taking a health history, performing a physical examination, evaluating lab results, and collaborating with other members of the health care team. Urine output less than 30 cc/hr. Give acetaminophen to control the child’s fever B. Our extensive library of care plans have been developed by nurses, for nurses to assist. Postoperative care. The nurse suspects a wound infection because the drainage on the dressing is yellow and thick. Clinical Pathway This abbreviated plan of care or care map is event- or task-oriented and provides outcome-based guidelines for goal achievement within a. Including care given throughout quick postoperative period, in the operating room and post anesthesia care unit (PACU), in addition to throughout the days following surgery. They may respond in a physical, behavioral, or functional manner. A nurse is caring for a client who has stage IV lung cancer and is 3 days postoperative following a wedge resection. Question 1 Question 1 See full question A client asks to be discharged from the health care facility against medical advice (AMA). Recent data suggest 80 percent of patients experience pain postoperatively 2 with between 11 and 20 percent experiencing severe pain. wrap each wrist with gauze dressing beneath the restraints c. Which of the following statements by the client indicates an understanding of the teaching?A. Choose an answer. An assistive personnel (AP) tells a charge nurse that it is unfair that she has to take care of all the clients who are incontinent. Nursing Times; 109: 22, 24-26. ID: 311038812 The nurse is teaching a client about precautions for a new prescription for lovastatin (Mevacor). Monitor the client’s mental status. 25 mg PO daily. The client who had a cholecystectomy 2 days earlier 4. The client has been maintained on a regimen of NPH and regular insulin and a 1,800-calorie diabetic diet with normal blood sugar levels. Monitor the client’s cardiac status (Peds p120) c. A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. The client's intake has exceeded the recommended amount for weight maintenance by 250 calories each day. Elevate the foot of the bed. The client who is on contact isolation for methicillin-resistant Staphylococcus aureus (MRSA) 2. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL 2) Total t4 level is 2 mcg/dL A nurse providing teaching to a client who has just been prescribed. Expiratory rales Atorvastatin prescription Peripheral vascular disease Potassium level of 3. Drainage at her incision line. Which of the following statements by the client indicates an understanding of the teaching?A. - A nurse is providing care for a client who is 2 days postoperative following abdominal surgery and is about to progress from a clear liquid diet to full liquids. Which of the following instructions should the nurse include in the teaching? 1) Take temperature once a day. The night shift nurse is caring for clients on the surgical unit. Monitoring of the patient's vital signs (and hence, the patient's general condition); including temperature to detect any fever which could develop due to an infection. When you do a follow-up call with this patient, you are informed that the patient is feeling better and is stopping the medication after taking it for 4 days. client who has not had a bowel movement in 4 days abdomen is firm b. What is the purpose of ambulating this client on the evening of the surgery? 3. A nurse is caring for a client who is 2 days postoperative following a gastric bypass. R: when using the urgent vs the nonurgent approach to care, the nurse should determine that the priority finding is a urine output of 20ml/hr, which is below the expected reference range and might indicate that the client is hypovolemic or experiencing renal failure. safe and effective method for controlling postoperative pain o For more severe pain, use intravenous narcotics (morphine sulfate 0. c) Money management. For this reason, the nurse, in collaboration with other members of the health care team, educates the client about palliative care and how this care differs from curative care. When the nurse assists the client out of bed for the first time, the client becomes dizzy. which of the. A nurse is caring for a client who is 3 days postoperative following a cholecystectomy. B) Instruct the patient to lie prone and measure tip of nose to umbilical area. Pallor and coolness of the affected When planning the client’s care, the leg nurse should give. Our community brings together students, educators, and subject enthusiasts in an online study community. 2: Examples of confused responses. Encourage the client to visit with the pastoral care department chaplain. Full liquid; 2. Preoperative care and patient education can be done in cases of elective amputation. Monitor for continence and urinary retention when the catheter is removed. In preparing the client and the family for a postoperative stay in the intensive care unit after open heart surgery, the nurse should explain that: a. lehne pharmacology for nursing care 7th edition test bank MULTIPLE CHOICE 1 A postoperative patient who is worried about pain control will be discharged several. Because the client is a known opioid substance abuser, the nurse plans care, knowing which piece of information? 1. Immediately post-op, the nurse should: Maintain the client in a semi-Fowler's position with the head and neck supported by pillows. The nurse tells the client to take the medication: a. and regular basis. E) Chronic gastritis. Which of the following instructions should the nurse include in the teaching? A nurse is contributing to the plan of care for a child who is in Buck’s traction. Assist the client into a position of comfort. 2) Wash the armpits and genitals with a gentle cleanser daily. Which client does the nurse assess first? a. A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP). After the hand-off report, which client should the nurse see first? a. The client will remain in the intensive care unit for 5 days b. CHAPTER 27 / Nursing Care of Clients with Kidney Disorders 783 NURSING CARE OF THE CLIENT HAVING A KIDNEY TRANSPLANT •Provide routine postoperative care as outlined in Chapter 7. Generally speaking, what is the latest post-op day that a wound infection may become evident?. The client who is 3 hours postoperative lung transplant. A nurse is caring for a client who is 2 days postoperative following a gastric bypass. Remove the pressure dressing every 2 hrs after the first 8 hrs c. A patient who is NPO (nothing by mouth) for scheduled surgery has been on long-term oral steroid therapy and should receive a dose of Prednisone 10 mg by mouth at 0600. 0g/dL b) initial weight 208 pounds, down to 203 pounds c) blood pressure 160/90mm Hg, down to 130/78mm Hg d) daily intake and output of 2100 ml intake and. and its peak at 4 p. ATI Pharmacology – Proctored Assesment Latest 2020 Graded A A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0. A nurse is caring for a client taking atorvastatin (Lipitor). A therapeutic nurse-client relationship that facilitates communication D. A look at perioperative care. 25 mg PO daily. the home care nurse visit a client diagnosed with chronic bronchitis. The client limits her visitors C. A nurse is caring for a client who was in a motor-vehicle crash 2 days ago and sustained fractures to his tibia, ulna, and several ribs. The client states, “I told myself that I would go through with the surgery and quit smoking, if I could just live long enough to see my daughter’s wedding. The trend shows no signs of stopping, 1-3 despite efforts by nursing educators to inform nurses and student nurses of their legal and. 25,26 Significant, often prolonged episodes of hypoxemia are common in hospitalized patients in the 48 hours after surgery and are frequently. The nurses taking care of the client should not share information that the client has told them with each other. It often includes pain management and wound. If mandated by state law or where feasible, exclude an exposed, asymptomatic health-care worker who is unable to receive chemoprophylaxis from providing care to a child aged <4 years during the period starting 7 days after the worker's first possible exposure until 14 days after his last possible exposure to a case of pertussis (II, IC) (287). The nurse is caring for a 30-year-old male admitted with a stab wound. The nurse identifies this type of drainage as. A client who is 2 days postoperative and has a urine output of 20ml/hr. NURSING CARE AND PATIENT EDUCATION a. More back pain than the first postoperative day B. The nurse should: Attempt to replace the cord. Nurses and caregivers have highly important roles at the end of life. vital signs are as follows: HR 104, BP 88/42, RR 38, T 100. 6) A nurse is evaluating discharge instructions for a client following a right cataract extraction. Determine the correct order of steps for this procedure. Monitor the client's cardiac status (Peds p120) c. needs to use bedpan or urinal while on bed rest, or a Foley catheter may be used. 2%) of all residents were admitted from a hospital or health care facility other than a nursing home or assisted-living-type facility, and 65. ATI Pharmacology – Proctored Assesment Latest 2020 Graded A A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0. American Geriatrics Society. NURS 3247 Pharmacology Proctored Assessment (Latest): University of Houston NURS3247 Proctored Pharmacology Exam / NURS 3247 Proctored Pharmacology Exam (Latest): University of Houston A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0. Nurse April is caring for a client who underwent a lumbar laminectomy 2 days ago. There is time to prepare the patient for what lies ahead. A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. Adequate vital signs and urinary output. The charge nurse observes an unlicensed assistive personnel (UAP) bending at the waist to lift a 20. The night shift nurse is caring for clients on the surgical unit. I have a specimen in the bathroom from about 30 minutes agoC. client who is very depressed and has eaten 10% of meals for the last 2 days. Elevate the stump on a pillow. Question 1 Question 1 See full question A client asks to be discharged from the health care facility against medical advice (AMA). Determine the correct order of steps for this procedure. NPO for 2-3 days or greater for GI surgery Mouth care if NPO - ice chips if allowed Emesis basin within reach Anti-emetics for nausea Urinary output –30-50 ml/hr or void within 8-12 hrs Color Odor Urge to void May have bloody urine post-op for urinary tract surgery Neuraxial Anesthesia. Which of the following instructions should the nurse include in the teaching? 1) Take temperature once a day. The nurse has changed this dressing daily since surgery. Give acetaminophen to control the child’s fever B. A nurse is caring for a postoperative client on the surgical unit. NR 324 Adult Health 1 Study Guide (2019-20 Miles) A nurse is caring for a client who requires a 24-hr urine collection. 2) Wash the armpits and genitals with a gentle cleanser daily. The client received 2 pain pills 2 hours ago. The nurse would monitor this client for which of the following? A) Cerebral anoxia B) Cardiac dysrhythmias C) Hypothyroidism D&rpar. The nurse would instruct the woman to notify her health care provider if she develops which of the following? A. A typical stay in the intensive care unit is 1-3 days and then you continue your post-operative care on a regular hospital floor. A nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul’s. Inform the client that he may pass small clots and tissue debris for several days. a nurse is caring for a client who is 2 days postoperative following bowel resection and reports sudden severe abdominal pain. Excellent physical, social, and emotional nursing assessments B. 1) You are caring for a cirrhotic client with jaundice. Rationale:Postoperative hemorrhage is most likely to occur during first 48 hr, whereas infection may develop at any time. a nurse in an ED is caring or a client who has advanced lung cancer. Inform the client that some burning, frequency, and dribbling may occur following catheter removal. This includes care given during the immediate postoperative period, both in the operating room and postanesthesia care unit (PACU), as well as during the days following surgery. • Important injectable drugs for pain are the opiate analgesics. The client understands postoperative care of artificial skin when he states that during the first 7 days after the procedure, he will restrict: range of motion. Postoperative care is provided by peri-operative nurses. What action by the nurse is best to promote comfort? a. Which of the following statements by the client indicates an understanding of the teaching?A. PACU nurse receives report from OR ; General info (name, age, surgery, etc) Medical History ; Intra-operative Course Management (meds, blood. After this education and counseling, the client should be encouraged to make a decision about whether or not they want palliative care after they have become. Which is the nurses best response? a. Surgical manipulation of the bowel disrupts peristalsis, resulting in an initial ileus. Which of the following is the best indicator that the client is experiencing pain? A. Chapter 03: Care of the Patient with an Integumentary Disorder 1)A patient has generalized macular-papular skin eruptions and complains of severe pruritus from contact dermatitis. A blood glucose level of 140 mg/dL is above the expected reference range and might require intervention; however, this is not the finding the nurse should report to the provider immediately. The client's rights to confidentiality do not apply to the break time of employees. Encourage the client to visit with the pastoral care department chaplain. The nurse is caring for pediatric clients. The RN with 8 years of experience caring for a client with peripheral arterial disease (PAD) and a total cholesterol of 390 mg/dL (10. Provide stimulation. remove the restraints every 2 hours and inspect the wrists b. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL 2) Total t4 level is 2 mcg/dL A nurse providing teaching to a client who has just been prescribed. While transferring to a chair, the client cries out in pain. A woman has undergone a cesarean birth is to be discharged. client who had a pulse of 89 and regular now has pulse of 100 and irregular c. Nurses must practice in a manner consistent with professional standards and be knowledgeable about professional boundaries. Implement measures to promote comfort. the nurse should recommend that the client a nurse is caring for a client after. Postoperative care: Postoperative care is the care you receive after a surgical procedure. Nursing Management: endovascularrepair postop care Supine 6 hours; head of bed elevated up to 45 degrees after 2 hours. chapter 5 Care of Postoperative Surgical Patients Objectives Theory 1. Which client situation would warrant immediate notification of the surgeon? 1. Incision Care. Client with a Pasero Scale score of 4 d. The nursing assistant has taken vital signs of the ventilated postoperative client who has had radical neck surgery. Which assessment data should the nurse notify the health care provider about prior to surgery? 1. 2) Wash the armpits and genitals with a gentle cleanser daily. Prevent infection at the incision site. A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. The nurse is caring for the 30-weeks-pregnant client who is having contractions every 11 /2 to 2 minutes with spontaneous rupture of membranes 2 hours ago. The nurse transfers the care of the client to another nurse. a nurse is caring for a client who is 2 days postoperative following bowel resection and reports sudden severe abdominal pain. A client who is scheduled for an ileostomy surgery and been taking corticosteroids is instructed to taper the drug, eventually discontinuing it. A paradoxical pulse occurs in a client who had coronary artery bypass graft (CABG) surgery 2 days ago. A nurse is caring for a postoperative client on the surgical unit. -Elevate ankle above the heart -Wrap ankle with an elasticized compression bandage -Apply intermittent cold compression for the first 24-48 hrs. •Provide routine preoperative care and teaching as explained in Chapter 7. The nurse notes that bowel sounds are present. The nurse is caring for a first day postoperative surgical client. Which of the following findings should the nurse consider abnormal? NCLEX practice questions. The client guards her surgical incision when ambulating. A nurse administers the influenza. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL 2) Total t4 level is 2 mcg/dL A. 25 mg PO daily. The nurse is assessing a patient's right knee, and the assessment reveals edema, tenderness, muscle spasms, and ecchymosis. Type 1 diabetes. One aspect of care is manipulation of the client's environment. A postpartum client overhears the nurse tell the health care provider that she has a positive Homans sign and asks what it means. An assistive personnel (AP) tells a charge nurse that it is unfair that she has to take care of all the clients who are incontinent. The client's pulse oximeter readings have fluctuated between 79% and 88% for the last 30 min. They may respond in a physical, behavioral, or functional manner. The client will sleep most of the time while in the intensive care unit. Compress and release the client’s toenails. Which of the following interventions should the nurse include in the plan of care? a. A Cesarean section (C-section) is surgery to deliver a. Which of the following pathophysiological mechanisms that occurs in the lung parenchyma allows pneumonia to develop? Atelectasis Bronchiectasis Effusion Inflammation 3. A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. Which of the following foods should the nurse provide at the initial feeding? A. INTRODUCTION. The clinic nurse is caring for a client diagnosed with osteoarthritis. In planning nursing care, the nurse would incorporate which of the following as the best strategy to assist the client in coping with the disease? 1. The nurse is caring for an older adult client who has had a hip replacement 2 days previously. The nurse would monitor this client for which of the following? A) Cerebral anoxia B) Cardiac dysrhythmias C) Hypothyroidism D&rpar. It consists of 74 nursing diagnoses, 133 nursing interventions, and 28 nurse-sensitive patient outcomes appropriate for use in any surgical setting. 60 minutes before breakfast d. A nurse is planning care for a preschool-age child who is in the acute phase of Kawasaki disease. 4. Use of a soft bed mattress to prevent contracture. Which client should the nurse assess first? 1. call physician to report antiemetic for client who has been vomiting. The nurse has changed this dressing daily since surgery. 25 mg PO daily. While transferring to a chair, the client cries out in pain. Explanation: Question 3 See full question. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits&sol. The nurse is caring for a client who is 2 days postoperative following an abdominal hysterectomy. A paradoxical pulse occurs in a client who had coronary artery bypass graft (CABG) surgery 2 days ago. Assist the client into a position of comfort. Which of the following interventions should the nurse include in the plan of care? a. The nurse is caring for pediatric clients. Introduction to cardiac surgery Immediate post-op care History Physical exam and assessment Labs and tests Warming Bleeding Surgical bleeding Etiology of "medical" bleeding Treatment of "medical" bleeding Transfusion of packed RBC's Hemodynamic management Hypotension and low cardiac output Inotropes and vasopressors Tamponade Mechanical assist devices Intra-aortic balloon pump Introduction to. Which of the following should the nurse plan to include in the verbal report?. Monitor the patient's pulmonary status closely and report any changes, such as pulmonary congestion, dyspnea, or SpO 2 below 92%. Pre and postoperative care. Leverage your professional network, and get hired. The client is sleeping quietly. CASE › Your patient, Mark Q, age 80, is admitted to the hospital to undergo hemicolectomy for colon cancer. Which of the following actions should the nurse take first? Determine areas of resonance across the abdomen using a systematic approach Expose the clients abdomen to look for changes in appearance. What should the nurse do first? You Selected: Have the client sign an AMA form. Monitor the client’s cardiac status (Peds p120) c. I have a specimen in the bathroom from about 30 minutes agoC. a nurse is caring for a client who is 2 days postoperative following bowel resection and reports sudden severe abdominal pain. The client who is Two days postoperative bladder surgery with continuous bladder irrigation infusing. A nurse is caring for a client who is postoperative following a wedge resection of a lung and has a chest tube with a water seal chest tube drainage system. Which of the following instructions should the nurse include in the teaching? 1) Take temperature once a day. 25 mg PO daily. The nurse reviews with the client a routine discharge teaching plan concerning postoperative care. A nurse in the health care provider's office is measuring vital signs on a postoperative client who underwent mastectomy of her right breast 2 weeks ago. POSTOPERATIVE NURSING CARE •Provide routine care for the surgical client (Chapter 7). In the case of a traumatic amputation, this may not be possible. Total Cards. Check client's INR Information on health care law to a group of newly licensed nurses. Instruct the client to flex and extend the knee. Monitor the patient's pulmonary status closely and report any changes, such as pulmonary congestion, dyspnea, or SpO 2 below 92%. The nurse is caring for a postoperative client whose diabetes has been controlled with oral. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL 2) Total t4 level is 2 mcg/dL A nurse providing teaching to a client who has. The bridge NURSING CARE OF THE CLIENT WITH A COLOSTOMY •Assess the location of the stoma and the type of colostomy per-formed. The client reports a burning pain in his chest. Pneumonia is an infection of the pulmonary tissue, including the interstitial spaces, the alveoli, and the bronchioles. to the following postoperative problems? a. There is time to prepare the patient for what lies ahead. docx), PDF File (. yellow over the first 2 to 3 days. Generally speaking, what is the latest post-op day that a wound infection may become evident?. vanilla pudding B. 25 mg PO daily. When planning care, which client should the nurse assess first? 1. A nurse on a telemetry unit is caring for a client who was admitted 2 hr ago and has chest pain. The client reports he has a history of "heart trouble," but has no problems at present. The client states, "I told myself that I would go through with the surgery and quit smoking, if I could just live long enough to attend my daughter's wedding. What supportive emotional measures can the nurse provide a hospitalized patient? 8. The role of the professional nurse in the perioperative care of the patient undergoing open heart surgery is beneficial for obtaining a positive outcome for the patient. A nurse eventually changes the bandage to a smaller one. I will take a stool softener until my eye is healed. That nurse was Florence Nightingale, defining the art of nursing in the 1850s. com Blogger 54 1 25 tag:blogger. Therefore, it is important you know how to properly care for a patient with a Jackson-Pratt drain. POSTOPERATIVE NURSING CARE •Provide routine care for the surgical client (Chapter 7). Although medical care is more advanced and technically more complex since that time, it was the dedication of a nurse (like you) to ensure aseptic practices despite the significant nursing demands of patient care that makes the difference for the patients—then and now. The client has been maintained on a regimen of NPH and regular insulin and a 1,800-calorie diabetic diet with normal blood sugar levels. The client is sleeping quietly. Ask the HCP for an antipsychotic medication. A nurse is caring for a client with tuberculosis who is fearful of the disease and anxious about the prognosis. 1 Whether the surgery is done with the patient on or off the cardiopulmonary bypass (CPB) machine (see "On pump or off?"), the postoperative nursing care is the same. The trend shows no signs of stopping, 1-3 despite efforts by nursing educators to inform nurses and student nurses of their legal and. A nurse on a telemetry unit is caring for a client who was admitted 2 hr ago and has chest pain. A nurse is caring for a client who has stage IV lung cancer and is 3 days postoperative following a wedge resection. The clinic nurse is caring for clients in a pediatric clinic. a diagnosis is based on the assessment data you have collected on the patient. 2%) of all residents were admitted from a hospital or health care facility other than a nursing home or assisted-living-type facility, and 65. A nurse is providing skin care to a client who has been incontinent in her bed. Seek care immediately if: Your arm or leg feels warm, tender, and painful. protein intake. application of the shampoo is repeated in 7 to 10 days. Less than 40% of calories from fat 3. and the nurse notes redness and edema. a nurse is caring for a client who is 2 days postoperative following bowel resection and reports sudden severe abdominal pain. Which of the following actions should the nurse take first? Determine areas of resonance across the abdomen using a systematic approach. A nurse is caring for a client who is 2 days postoperative following an above the knee amputation. Turning the client from side to side d. Nurse is reviewing a client's medication administration record and finds that client has not received prescribed dose of Warfarin for past 2 days. The client has been vomiting for the past 24 hr and reports a pain level of 8 on a scale from 0 to 10. When teaching the patient about his new diagnosis, how should the nurse best describe a peptic ulcer? A) Inflammation of the lining of the stomach B) Erosion of the lining of the stomach or intestine C) Bleeding from the mucosa in the stomach D) Viral invasion of the stomach wall Ans: B Feedback: A peptic ulcer. Which client situation would warrant immediate notification of the surgeon? 1. The client diagnosed with Parkinson's disease who began to hallucinate during the night. Providing perioperative nursing care for patients who are to undergo Mastectomy is an integral part of the therapeutic regimen. Postoperative Ileus (POI) is a frequent, frustrating occurrence for patients and surgeons after abdominal surgery. The following aspects of postoperative care apply to all patients who've had CABG surgery. An aim is a desired long-term outcome to be achieved in a specified time (Ewles and Simnett, 1999). 2 lbs) in 24 hr. ATI Med-Surg 1. Elevate the client's hips. Once the surgeon is satisfied that the join is complete, it is tested to confirm that it does not leak, and then the surgical site is closed so the patient can be brought out of anesthesia. Client who is crying and agitated b. The client becomes angry and tells the nurse that there is nothing wrong with him and that he is going home immediately. 6) A nurse is evaluating discharge instructions for a client following a right cataract extraction. After assessing the client, the nurse administers furosemide as prescribed. Cover the cord with a dry, sterile gauze. Absence of ventricular tachycardia. Place the client on her left side. Postoperative respiratory depression is a significant source of postoperative morbidity and mortality, ranging from transient hypoxemia to severe ventilatory impairment leading to brain damage or death. Recent data suggest 80 percent of patients experience pain postoperatively 2 with between 11 and 20 percent experiencing severe pain. Free, fast and easy way find a job of 25. The client who is 2 days postoperative for bowel resection and who refuses to turn, cough, and deep breathe. 3) Change the litter boxes while wearing gloves. The appropriate initial nursing action is to A. 3º C) Ans: C Chapter: 65 Client Needs: D-4 Cognitive Categories: Analysis. The bruise at your catheter site gets bigger or becomes swollen. Aortic regurgitation c. Postoperative delirium in the elderly. The nurse is caring for a 73-year-old female client who is 3 days postoperative for a bowel obstruction. Which of the following complications should the nurse suspect?. A nurse is caring for a client who has viral pneumonia. Client with a verbal pain report of 9 ANS: C. The patient is receiving O2 at 2 L per nasal cannula with a pulse oximetry reading of 95%. The client diagnosed with congestive heart failure who has 3_ pitting edema of both feet. application of the shampoo is repeated in 7 to 10 days. Rogers is 2 days postoperative of a thoracotomy for removal of a malignant mass in his left chest. The colostomy would typically not begin functioning until 2-4 days after surgery. A client who is scheduled for an ileostomy surgery and been taking corticosteroids is instructed to taper the drug, eventually discontinuing it. 3% of all residents had some kind of advance directive (SOURCE: National Nursing Home. The nurse knows that the stress response of surgery causes fluid-balance changes in the second to fifth postoperative day, when aldosterone, glucocorticoids, and antidiuretic hormone (ADH) are increasingly secreted, causing sodium and chloride retention and potassium excretion. Blood glucose 140 mg/dL. Ans: B, C, D. diet ginger ale D. I flushed what I urinated at 7. A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL 2) Total t4 level is 2 mcg/dL A. Which of the following interventions is important? Strain all urine Limit fluid intake Enforce strict bed rest Encourage a high calcium diet 2. Which assessment finding is the best indicator that the client does not need pain medication at this time? a. pdf), Text File (. The client understands postoperative care of artificial skin when he states that during the first 7 days after the procedure, he will restrict: range of motion. Kaplan NCLEX-RN Question Trainer Tests 1-7 Price: $19 on Sale for $5 Published: 2014 Kaplan study program for NCLEX-RN. chapter 5 Care of Postoperative Surgical Patients Objectives Theory 1. 2 g/dL and hematocrit of 36. Seek care immediately if: Your arm or leg feels warm, tender, and painful. The nurse determines that delivery is imminent. A nurse is preparing to place a patients ordered nasogastric tube. Cross-allergies exist between. Feedback:. Her cervix is 8 cm dilated and 100% effaced. An enterostomal nurse therapist is a registered. After cardiac surgery, a client's blood pressure measures. The cause of diabetes depends on the type. The client states, “I told myself that I would go through with the surgery and quit smoking, if I could just live long enough to see my daughter’s wedding. NURS 3247 ATI Pharmacology - Proctored Assessment (Spring 2020) ATI Pharmacology - Proctored Review A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0. After 6 weeks of treatment the nurse dtermines that the medication was effective if the: 1) Thyroid stimulating hormone (TSH) level is 2 microunits/mL 2) Total t4 level is 2 mcg/dL A nurse providing teaching to a client who has just been prescribed. Raise all four side rails on the client’s bed. The client's pulse oximeter readings have fluctuated between 79% and 88% for the last 30 min. Nearly one-half (48. A client is complaining of severe flank and abdominal pain. Administer antibiotics via intermittent IV bolus for 24 hrs d. The client states that she has no pain. Which of the following statements by the client indicates an understanding of the teaching?A. Postoperative care is provided by peri-operative nurses. Clinical Pathway This abbreviated plan of care or care map is event- or task-oriented and provides outcome-based guidelines for goal achievement within a. 2 Use specific agency criteria for determining readiness of the patient to be discharged from the postanesthesia care unit. The nurse is caring for a client who is reporting severe postoperative pain. fluid ingestion. 2 g/dL and hematocrit of 36. Search and apply for the latest Home care nurse dha jobs. Less than 7% of calories from saturated fat 129. Pain on the incision site. Our community brings together students, educators, and subject enthusiasts in an online study community. While in the emergency room, a chest tube is inserted. c) Money management. Lying client in the prone position every 3-4 hours. an accredited program to care for clients with d. Monitor the patient's pulmonary status closely and report any changes, such as pulmonary congestion, dyspnea, or SpO 2 below 92%. The client tells the nurse that she is very concerned because she has numbness in the area of the surgery and along the inner side of the arm from the armpit to the elbow. Br J Anaesth. 102 A LPN complains to the charge nurse that an unlicensed assistive person (UAP) consistently leaves the work area untidy and does not restock supplies. lehne pharmacology for nursing care 7th edition test bank MULTIPLE CHOICE 1 A postoperative patient who is worried about pain control will be discharged several. #N#When preparing a client for an enema, the nurse should help him into the: left-lateral Sims' position.