The prescription that requires clarification by the provider is Bumetanide 1mg IV bolus every 12 hours. So the correct option is D.
Bumetanide is a loop diuretic commonly used in the management of heart failure to promote diuresis and reduce fluid overload. However, the prescription lacks important information such as the frequency and duration of administration. The instruction to administer the medication every 12 hours is unclear regarding the total number of doses to be given and the overall treatment plan.
To ensure safe and effective medication administration, the nurse should seek clarification from the provider regarding the frequency, duration, and any specific parameters for the administration of Bumetanide. This may include details on the desired diuresis goals, titration based on the client's response, or adjustment based on electrolyte levels and renal function.
The other options (A, B, and C) do not require immediate clarification as they provide clear instructions. Option A outlines the administration of morphine sulfate as needed for pain relief. Option B requests laboratory testing of serum potassium upon admission, which is a routine practice to assess electrolyte levels. Option C instructs the continuous infusion of 0.9% normal saline at a specific rate for hydration.
Addressing the clarification needed for the Bumetanide prescription ensures the nurse has clear guidance for appropriate administration, monitoring, and evaluation of the client's response to the medication.
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which health screening and immunization recommendations are appropriate for a 48-year-old client? select all that apply. one, some, or all responses may be correct.
Health screening for blood pressure, blood glucose level, HIV, obesity, cholestrol level should be recommended in elderly people.
In order to identify potential abnormalities or diseases in persons who don't exhibit any symptoms, a screening test is performed. The objective is to either detect a disease early enough to allow for the most effective treatment or to find it early enough to allow for lifestyle adjustments and closer monitoring to lower the risk of disease.
Screening tests are used to decide whether further testing is necessary even though they are not thought of as diagnostic. To reduce the risk of disease or to discover it early enough to obtain the best care, the goal is early identification, lifestyle changes, or surveillance.
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The complete question is:
What health screening and immunization recommendations are appropriate for a 48-year-old client?
the nurse notes that a patient with liver disease has had nausea and vomiting. this is most likely a side effect of:
Answer:
Nausea and vomiting are common side effects of liver disease. The liver plays a vital role in processing nutrients and toxins in the body, and when it is not functioning properly, it can lead to a buildup of toxins in the blood, which can cause nausea and vomiting. Additionally, liver disease can cause inflammation in the stomach lining, which can also contribute to nausea and vomiting. Therefore, the most likely cause of the patient's nausea and vomiting is their liver disease.
Benzocaine (Americaine) is used to treat which of the following? Select all that apply. A. Sunburn B. Insect bites. D. Pruritus.
Benzocaine (Americaine) is a local anesthetic that is used to relieve pain and itching caused by minor skin irritations, such as insect bites, sunburn, and pruritus (itching). It works by numbing the skin and reducing the sensitivity of nerve endings. Therefore, the correct answers to this question are A, B, and D.
Sunburn is a common condition that results from overexposure to the sun's ultraviolet rays. It can cause redness, pain, and itching of the affected skin. Benzocaine can provide relief from these symptoms by reducing the sensation of pain and itching.
Insect bites are another common skin irritation that can cause itching, swelling, and pain. Benzocaine can be used topically to provide relief from these symptoms and reduce the discomfort associated with insect bites.
Pruritus is a medical term for itching, which can be caused by a variety of conditions, such as allergies, dry skin, or insect bites. Benzocaine can be used to relieve the itching associated with these conditions by numbing the affected area and reducing the sensation of itching.
In conclusion, benzocaine (Americaine) is a useful medication for the treatment of sunburn, insect bites, and pruritus. However, it is important to follow the instructions on the label and consult with a healthcare provider before using it to ensure safe and effective use.
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the nurse is talking to a group of community volunteers about food allergies. what are the foods that cause the most severe allergic reactions and result in the highest client death rates?
The foods that may be able to cause allergy are; fish, egg, nuts, wheat, shellfish.
What is food allergy?About 90% of all food allergies are related to these items, and they also cause most severe allergic reactions and anaphylaxis. A severe allergic reaction known as anaphylaxis can result in symptoms like trouble breathing, swelling of the tongue and throat, hives or other skin rashes, low blood pressure, and loss of consciousness. Anaphylaxis can be fatal if it is not promptly treated.
It is significant to remember that food allergies can be unpredictable, and that in some people, even minute amounts of an allergen can cause a severe reaction.
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which items would the nurse include in the assessment of the integumentary system for a preoperative client
Assessing the integumentary system of a preoperative client involves all the options given, options A, B, C, & D are correct.
Assessing the integumentary system of a preoperative client involves checking the skin for redness, rash, or discoloration, as these can indicate inflammation or infection. Skin lesions, such as moles or warts, should be assessed for changes in size, shape, or color, as well as irregular borders or bleeding.
Checking the nails is important for signs of infection, such as discoloration, thickening, or separation from the nail bed. Lastly, assessing the hair and scalp can reveal signs of dandruff, itching, or hair loss. All of these assessments are important for identifying any potential issues that may need to be addressed prior to surgery, options A, B, C, & D are correct.
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The complete question is:
Which items would the nurse include in the assessment of the integumentary system for a preoperative client, select all apply.
A. Checking the skin for any signs of redness, rash, or discoloration.
B. Assessing any skin lesions, such as moles, warts, or bumps, for any changes or signs of malignancy.
C. Checking the nails for any signs of infection, such as discoloration, thickening, or separation from the nail bed.
D. Assessing the hair and scalp for any signs of dandruff, itching, or hair loss.
a patient with mania has not eaten or slept for 3 days. which nursing diagnosis has priority? group of answer choices risk for injury ineffective coping ineffective management of therapeutic regime imbalanced nutrition, less than body requirements
The nursing diagnosis that has priority in this scenario is Imbalanced Nutrition, less than body requirements.
When a patient with mania has not eaten or slept for 3 days, the priority nursing diagnosis is Imbalanced Nutrition, less than body requirements. The patient is at risk of developing malnutrition, dehydration, and electrolyte imbalances due to inadequate intake of food and fluids.
The nurse should assess the patient's weight, intake and output, and laboratory results, including electrolytes and blood glucose levels. The nurse should also encourage the patient to eat and drink, provide small, frequent meals, and monitor the patient's response to food and fluid intake.
The nurse should collaborate with the healthcare team to establish an appropriate nutritional plan and provide education to the patient and family about the importance of adequate nutrition. In addition, the nurse should monitor the patient's sleep patterns and collaborate with the healthcare team to develop a plan to promote sleep.
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Damage to the ________ would be expected to impair instrumental learning in rats.
a. amygdala
b. hypothalamus
c. frontal cortex
d. basal ganglia
e. accumbens
Damage to the basal ganglia would be expected to impair instrumental learning in rats. The correct option is d. basal ganglia. The basal ganglia is a collection of nuclei located in the brain that are involved in the control of movement, cognition, and emotions.
It is also involved in instrumental learning, which is the process of learning how to perform a specific action in order to achieve a desired outcome or reward. Damage to the basal ganglia would be expected to impair this type of learning in rats.
Studies have shown that lesions in the basal ganglia can lead to deficits in instrumental learning in rats. For example, rats with damage to the basal ganglia have been found to have difficulty learning to press a lever in order to receive a food reward. This suggests that the basal ganglia plays an important role in the acquisition and execution of goal-directed actions.
In summary, damage to the basal ganglia would be expected to impair instrumental learning in rats, as this brain region is critical for the control of movement and the learning of goal-directed actions.
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a nurse is caring for a client with a fractured hip. the client is combative, confused, and trying to pull out necessary i.v. lines and an indwelling urinary catheter. the nurse should
The nurse should **prioritize ensuring the safety of the client and implement appropriate interventions** to address their combative behavior and prevent self-harm or harm to others. It is crucial to maintain a calm and controlled environment while providing necessary care.
Potential interventions include:
1. **Verbal de-escalation**: The nurse can use a calm and reassuring tone to communicate with the client, providing simple and clear instructions to redirect their behavior.
2. **Reorientation and therapeutic communication**: The nurse can attempt to reorient the client to their surroundings and situation. Using therapeutic communication techniques, such as validation and empathy, can help establish rapport and reduce agitation.
3. **Physical interventions**: If necessary, the nurse may need to implement physical interventions to ensure the safety of the client and healthcare team. This can involve seeking assistance from additional staff members, using appropriate restraints or protective devices as per facility protocols, or employing techniques to safely immobilize the client while avoiding injury.
4. **Pharmacological interventions**: In severe cases where verbal de-escalation and physical interventions are not effective, the healthcare provider may prescribe medications to manage the client's agitation, such as sedatives or antipsychotics. The nurse should administer these medications according to the prescribed guidelines and closely monitor the client's response.
The specific interventions should be determined based on the individual client's needs, facility policies, and collaboration with the healthcare team. Prompt documentation and reporting of the incident are essential to ensure continuity of care and maintain a safe environment for the client.
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the assumption that will be most useful to the nurse planning crisis intervention for any patient who is experiencing a crisis is that the patient: group of answer choices is experiencing a type of mental illness. is experiencing a state of disequilibrium. has high potential for self-injury. poses a threat of violence to others.
The assumption that will be most useful to the nurse planning crisis intervention for any patient who is experiencing a crisis is that the patient is experiencing a state of disequilibrium.
When a patient is experiencing a crisis, it is important for the nurse to recognize that the patient is in a state of disequilibrium, meaning that they are struggling to cope with a situation or circumstance that is beyond their current capacity to manage.
This may be due to a variety of factors, such as a traumatic event, loss, or overwhelming stress. By assuming that the patient is in a state of disequilibrium, the nurse can approach the situation with empathy and understanding, and work to help the patient regain a sense of stability and control.
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T/F. for most performers, instructing them to pay attention to aspects of the movement itself, rather than the intended result of an action, produces a more skilled performance.
The given statement for most performers, instructing them to pay attention to aspects of the movement itself, rather than the intended result of an action, produces a more skilled performance is true.
Instructing performers to pay attention to aspects of the movement itself, such as body position, timing, and coordination, rather than the intended result of an action, can produce a more skilled performance. This approach, known as "process-focused instruction," encourages performers to focus on the process of performing the movement, rather than solely on the outcome.
By doing so, performers can better fine-tune their movements and make adjustments as necessary, leading to improved overall performance. Additionally, process-focused instruction can help reduce anxiety and pressure related to achieving a specific outcome, allowing performers to focus on the present moment and the task at hand.
Overall, process-focused instruction has been found to be an effective method for improving performance in a variety of contexts, from sports to dance to music.
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While assessing a patient with endometriosis, the nurse finds the patient shows signs of anxiety. Which might be the reason for the patient's condition?
Infertility
Chronic pelvic pain
Inflammation of endometrial implants
Scarring of endometrial implants
The reason for a patient with endometriosis showing signs of anxiety could be any of the following factors: infertility, chronic pelvic pain, inflammation of endometrial implants, or scarring of endometrial implants. These factors are common complications of endometriosis and can cause physical and emotional distress for the patient.
Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside of it, causing pain and discomfort. Infertility, chronic pelvic pain, inflammation, and scarring are some of the complications that can arise from this condition. These complications can lead to emotional distress and anxiety in patients.
Therefore, it is important for healthcare providers to assess and address the mental health needs of patients with endometriosis to provide holistic care. Treatment options include medication, surgery, and lifestyle changes to manage symptoms and improve quality of life.
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when preparing a client who is scheduled for a pulmonary function test (pft) because of possible adult-onset asthma, which action would the nurse take? have client use the prescribed as needed bronchodilator before testing.
Depending on the healthcare provider's specific instructions, the nurse may need to instruct the client to use their prescribed as-needed bronchodilator before the test.
It is important for the nurse to follow the healthcare provider's orders regarding the preparation of a client who is scheduled for a pulmonary function test (PFT) because of possible adult-onset asthma.
Bronchodilators are medications that relax the muscles in the airways, which can help open up the air passages and improve breathing. If the client has been prescribed an as-needed bronchodilator for their asthma, it may be appropriate for them to use it before the PFT to help ensure accurate results.
By opening up the airways, the bronchodilator can help the client breathe more easily and fully during the test, which can help provide a more accurate assessment of their lung function.
However, it is important to note that the specific instructions for using bronchodilators before a PFT may vary depending on the type of test being performed and the healthcare provider's preferences.
Therefore, it is essential for the nurse to consult with the healthcare provider or the facility's policy and procedure guidelines to ensure that the client is properly prepared for the test.
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which nursing action would be contraindicated for a client with a newly applied long leg plaster cast?
One nursing action that would be contraindicated for a client with a newly applied long leg plaster cast is raising the cast above the level of the heart.
This can lead to increased swelling and pain due to impaired blood flow and increased pressure on the area. Another contraindicated nursing action is allowing the client to bear weight on the cast too soon, which can lead to a weakened cast and possible displacement or fracture of the affected bone. Additionally, the cast should not be covered with anything, such as plastic or blankets, as it can interfere with proper drying and hardening of the cast, leading to deformities or uneven pressure on the skin.
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the nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. the mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. what question would the nurse ask?
The nurse may ask if the child has had any recent trauma to her mouth or if she has been exposed to any medication or substances that may cause tooth discoloration.
The nurse may also inquire about the child's dietary habits, specifically if she consumes a lot of sugary or acidic foods and drinks. Additionally, the nurse may ask about any underlying medical conditions that the child may have that could contribute to tooth discoloration.
The nurse may also ask about the child's dental history, including any previous dental procedures or orthodontic treatment. By gathering more information through questioning, the nurse can better understand the cause of the tooth discoloration and provide appropriate interventions or referrals.
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the psychiatric nurse is presented with a group of clients in the emergency department. which client requires immediate attention
A young adult client who failed medical school and says, "My pain will be over soon" requires immediate attention from the psychiatric nurse, option 1 is correct.
The risk of self-harm is a medical emergency that requires prompt intervention to ensure the safety of the client. The nurse should assess the client's level of risk, initiate appropriate interventions, and coordinate further care to address the underlying issues contributing to the client's distress.
The psychiatric nurse may also need to collaborate with other healthcare providers, such as a psychiatrist or social worker, to develop a comprehensive care plan to address the client's mental health needs, option 1 is correct.
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The complete question is:
A psychiatric nurse is presented with a group of patients to the ER. Which of the following patients require immediate attention?
1. A young adult client who failed medical school and says, "My pain will be over soon."
2. An adult client who is unable to talk in front of other people due to symptoms of anxiety.
3. A middle-aged client who hears voices saying to harm others.
4. A middle-aged client who is anxious after witnessing a murder.
During an annual physical assessment a client reports not being able to smell coffee and most foods. Which cranial nerve function should the nurse assess?
The nurse should assess the function of cranial nerve I, the olfactory nerve, during an annual physical assessment if a client reports not being able to smell coffee and most foods.
The olfactory nerve is responsible for the sense of smell. Impaired olfactory function may indicate an issue with this specific cranial nerve. During the assessment, the nurse can use various non-irritating odors to test the client's ability to identify smells. If the client struggles with this task, it could suggest a problem with the olfactory nerve. It is important for the nurse to also consider other factors that may contribute to the client's impaired sense of smell, such as a recent cold, sinus congestion, or allergies.
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what are the major challenges for blood brain barrier (bbb)? what strategies could be used to help nanoparticles go through the bbb for drug delivery into the brain?
The blood brain barrier (BBB) is a complex structure that separates the blood vessels in the brain from the brain tissue, providing a selective barrier that controls the exchange of molecules between the two compartments. While this barrier is essential for protecting the brain from harmful substances, it also presents a major challenge for drug delivery into the brain.
One of the major challenges for the BBB is its selective permeability. The tight junctions between endothelial cells that form the BBB restrict the passage of molecules and nanoparticles. This makes it difficult for drugs to reach the brain tissue, as they are often too large or too hydrophilic to cross the barrier.Another challenge is the efflux transporters that are present on the luminal membrane of the endothelial cells. These transporters actively pump out drugs that have managed to cross the BBB, reducing their efficacy in the brain.
To overcome these challenges, various strategies have been proposed to enhance drug delivery across the BBB. One approach is to use nanoparticles that can bypass the selective permeability of the BBB. Nanoparticles can be designed to have a small size, low surface charge, and high lipophilicity, allowing them to penetrate the BBB and reach the brain tissue.
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the nurse suspects drug toxicity in the client who has been receiving lidocaine by infusion to control a ventricular arrhythmia. what assessment should the nurse perform to determine the accuracy of the suspicion of toxicity?
When a nurse suspects drug toxicity in a patient receiving lidocaine by infusion to control a ventricular arrhythmia, there are several assessments that should be performed to determine the accuracy of the suspicion.
Firstly, the nurse should assess the patient's vital signs, paying close attention to the heart rate and rhythm, as well as blood pressure and respiratory rate. Next, the nurse should assess the patient's level of consciousness, looking for signs of confusion, dizziness, or altered mental status, as these may be indicative of toxicity. The nurse should also assess the patient's urine output and electrolyte levels, as lidocaine toxicity can lead to renal impairment and electrolyte imbalances. Additionally, the nurse should monitor the patient's ECG, looking for changes in the QT interval or other signs of arrhythmia. If the nurse suspects drug toxicity, they should notify the healthcare provider immediately and prepare to administer appropriate interventions, such as discontinuing the lidocaine infusion, administering antidotes, and providing supportive care as necessary.
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which client statement about gerd triggers requires further nursing teaching? select all that apply.
The correct option is B, The client statement that requires further nursing teaching is "smoking one or two cigarettes a day won't hurt."
Nursing is a profession dedicated to promoting, maintaining, and restoring the health and well-being of individuals, families, and communities. Nurses are trained healthcare professionals who provide patient care, educate patients and families about health issues, and advocate for the needs and rights of patients.
Nurses work in a variety of settings, including hospitals, clinics, schools, and long-term care facilities. They play a crucial role in the healthcare system and work collaboratively with other healthcare professionals to provide comprehensive and compassionate care to patients. Nursing requires a broad range of skills, including critical thinking, communication, and empathy. Nurses must be able to assess patients, develop care plans, administer medications and treatments, and provide emotional support to patients and their families.
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Complete Question:
Which client statement about GERD triggers requires further nursing teaching?
A. "I will decrease my alcohol intake."
B. "smoking one or two cigarettes a day won't hurt."
C. "my plan is to eat six small meals daily."
D. "tomato-based foods should be avoided."
E. "I love soda but I'm going to stop drinking it."
F. "our family eats tacos and burritos several times weekly"
bacterial vaginonsis can affect both sexually active and non-active women.
Bacterial vaginosis (BV) is a common vaginal infection that can affect both sexually active and non-active women.
It occurs when the balance of bacteria in the vagina is disrupted, leading to an overgrowth of harmful bacteria. Risk factors for BV include douching, multiple sexual partners, and the use of certain antibiotics or hygiene products. Symptoms can include a fishy odor, vaginal discharge, and itching or burning.
Treatment typically involves antibiotics, but it is important to practice good hygiene and avoid douching to prevent recurrence. Overall, anyone with a vagina is susceptible to developing BV, regardless of sexual activity.
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A client is at risk for lung cancer asks about the reason for having a computed tomography (CT) scan as part of the initial exam. What is the nurse's best response? "A CT Scan is:
A. Far superior to magnetic resonance imaging for evaluating lymph node metastasis."
B. Noninvasive and readily available."
C. Useful for distinguishing small differences in tissue density and detecting nodal involvement."
D. Used to distinguish a malignant from non-malignant adenopathy."
The nurse's best response would be option C: "A CT scan is useful for distinguishing small differences in tissue density and detecting nodal involvement." This is because CT scans are an important diagnostic tool for lung cancer, as they can help identify tumors and determine their size, location, and potential spread to nearby lymph nodes.
The nurse's best response to the client at risk for lung cancer about the reason for having a computed tomography (CT) scan as part of the initial exam is option C. A CT scan is useful for distinguishing small differences in tissue density and detecting nodal involvement. CT scans use X-rays to create detailed images of the inside of the body, which allows healthcare providers to detect abnormalities, such as tumors, nodules, or other lung-related diseases.
CT scans are noninvasive and readily available, which makes them a useful tool for the early detection and diagnosis of lung cancer. While other imaging modalities, such as magnetic resonance imaging (MRI), may also be used in the evaluation of lymph node metastasis, CT scans are generally preferred due to their high resolution and ability to provide detailed images of the lungs. It is important for clients at risk for lung cancer to have regular screenings, including CT scans, to detect any abnormalities early and improve their chances of successful treatment.
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when providing education regarding options for weight loss for people who are obese, the nurse will report which intervention is the most effective for severe obesity?
Bariatric surgery is the most effective intervention for severe obesity.
Obesity is a chronic condition that can lead to serious health problems, including type 2 diabetes, heart disease, and stroke. Weight loss interventions can include lifestyle changes such as diet and exercise, medications, and surgery.
While lifestyle changes and medications can be effective for some people, bariatric surgery has been shown to be the most effective intervention for those with severe obesity, defined as a body mass index (BMI) of 40 or greater, or a BMI of 35 or greater with obesity-related health problems.
Bariatric surgery can result in significant and sustained weight loss, as well as improvements in obesity-related health problems. However, it is important to note that bariatric surgery is not appropriate for everyone and should be considered carefully in consultation with a healthcare provider.
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after the scrub person dons sterile gloves using the closed-glove method, what is the next step?
After the scrub person dons sterile gloves using the closed-glove method, the next step is to perform the surgical scrub. This involves thoroughly washing and disinfecting the hands and forearms to remove any bacteria or other microorganisms.
That could cause an infection during the surgical procedure. The scrub person will use an antiseptic solution and scrub brush to thoroughly clean all areas of their hands and forearms, including under the nails and between the fingers. Once the surgical scrub is complete, the scrub person can proceed with assisting the surgeon during the procedure while maintaining strict sterile technique to prevent contamination. It is important for all members of the surgical team to follow proper protocol and procedures to ensure patient safety and successful outcomes.
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Which of the following are plant proteins not an excellent source for?
A. Vitamin B12
B. Potassium
C. Fiber
D. Folate
Among the options provided, the plant proteins are not an excellent source of Vitamin B12 (option A).
Vitamin B12 is primarily found in animal-derived foods such as meat, fish, dairy products, and eggs. It is relatively scarce in plant-based sources, making it difficult for vegans and vegetarians to obtain sufficient amounts solely from plant proteins. Therefore, option A is the correct answer.
However, it's worth noting that plant proteins can be good sources of other nutrients. For example, they can provide potassium (option B), fiber (option C), and folate (option D) in varying amounts, depending on the specific plant-based foods consumed.
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a physician orders a single dose of trimethoprim/sulfamethoxazole by mouth for a client diagnosed with an uncomplicated urinary tract infection. the pharmacy sends three unit-dose tablets. the nurse verifies the physician's order. what should the nurse do next?
The nurse should call the physician to verify the order. Option b is correct.
The physician's order is for a single dose trimethoprim/sulfamethoxazole, but the pharmacy sent three unit-dose tablets. The nurse should clarify the discrepancy with the physician to ensure the correct dosage is administered. Giving one tablet three times per day or giving all three tablets at once would not follow the physician's order and could result in an incorrect dose being administered.
Calling the hospital pharmacist may be appropriate if there is a concern about the medication supplied, but it does not address the discrepancy in the order. The nurse's priority is to verify the physician's order and ensure the safe administration of the medication to the client. Hence Option b is correct.
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The complete question is:
A physician orders a single dose of trimethoprim/sulfamethoxazole by mouth for a client diagnosed with an uncomplicated urinary tract infection. The pharmacy sends three unit-dose tablets. The nurse verifies the physician's order. What should the nurse do next?
a. Give one tablet three times per day.b. Call the physician to verify the order.c. Call the hospital pharmacist and question the medication supplied.d. Give one tablet three times per day.treatment planning for a patient with grandiose thinking associated with acute mania will focus on: group of answer choices developing an optimistic outlook. distorted thought self-control. interest in the environment. body image.
Treatment planning for a patient with grandiose thinking associated with acute mania will focus on distorted thought self-control, option B is correct.
When treating a patient with grandiose thinking associated with acute mania, the primary goal is to address the symptoms of mania and stabilize the patient's mood. Distorted thought self-control refers to the ability to recognize and challenge irrational thoughts and replace them with more realistic and adaptive ones.
This is essential in treating mania, as grandiose thinking is a symptom of irrational and distorted thoughts. Treatment planning for a patient with grandiose thinking associated with acute mania may involve pharmacotherapy, such as mood stabilizers and antipsychotics, as well as psychotherapy, such as cognitive-behavioral therapy (CBT), option B is correct.
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The complete question is:
Treatment planning for a patient with grandiose thinking associated with acute mania will focus on: (group of answer choices)
A. developing an optimistic outlook
B. distorted thought self-control
C. interest in the environment
D. body image
the nurse notices that a client has a brilliant smile when asked about children. what should the nurse document about this finding?
The nurses documented this finding that the patient's cranial nerve Vii is intact.
Cranial nerve VII, also known as the facial nerve, is responsible for controlling the muscles of facial expression, including those involved in smiling. When cranial nerve VII is intact and functioning properly, the patient should be able to smile symmetrically with both sides of their face.
Damage or dysfunction of cranial nerve VII can lead to various facial muscle weaknesses or paralysis, resulting in the inability to smile, frown, close the eyelids, or raise the eyebrows on the affected side of the face. Therefore, assessing the function of cranial nerve VII is an essential part of the neurological examination.
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a nurse who works on a busy medical unit has been experiencing dry, itchy, reddened hands that she believes are a result of the frequent hand-washing that her job requires. what should the nurse's colleague recommend for the relief of this problem?
The nurse's colleague should recommend using a fragrance-free moisturizer regularly to relieve the dry, itchy, and reddened hands caused by frequent hand-washing.
The constant hand-washing and use of hand sanitizers can strip the skin of natural oils, leading to dryness, itching, and redness. Using a fragrance-free moisturizer can help to rehydrate the skin and soothe the irritation caused by frequent hand-washing. It is important to use a fragrance-free moisturizer because fragrances can further irritate the skin.
Additionally, the nurse should use warm, not hot water, when washing her hands and avoid harsh soaps. If the dryness and itching persist or worsen, the nurse should seek medical attention as it may be a sign of a more severe skin condition.
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When removing the dressing on a patient, the nurse discovers that the gauze dressing has adhered to the wound. What intervention should the nurse implement?
a. Call the RN
b. Gently remove the gauze with sterile forceps
c. Cover with occlusive dressing
d. Moisten the dressing with sterile water
When the nurse discovers that the gauze dressing has adhered to the wound, the appropriate intervention would be to moisten the dressing with sterile water.
When a gauze dressing adheres to a wound, it is important to avoid causing further injury or discomfort to the patient. Moisten the dressing with sterile water, which can help to gently loosen the gauze from the wound surface without causing excessive pain or trauma. By moistening the dressing, it can be more easily and safely removed, minimizing the risk of disrupting the wound and promoting a more comfortable experience for the patient. After moistening the dressing, it can be carefully and gently removed, ensuring that any remaining pieces of gauze do not get left behind in the wound. Once the dressing is fully removed, assess the wound for any signs of infection, redness, or other abnormalities, and proceed with appropriate wound care and re-dressing as necessary. Remember to maintain proper sterile technique throughout the process to prevent infection or further complications.
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the nurse is planning the care of an 8-year-old boy who has been diagnosed with atopic dermatitis. in the boy's plan of nursing care, what nursing diagnosis should the nurse prioritize?
Atopic dermatitis is a chronic inflammatory skin condition that commonly affects children. The nurse should prioritize nursing diagnoses that address the child's physical and emotional needs. One priority nursing diagnosis would be "Risk for Impaired Skin Integrity related to frequent itching and scratching."
The nurse should educate the child and family about the importance of avoiding triggers, using non-irritating moisturizers, and following a prescribed medication regimen. Another nursing diagnosis that should be prioritized is "Disturbed Body Image related to the appearance of the skin lesions." The nurse should provide emotional support and encourage the child to express his feelings about the condition. The nurse should also work with the child and family to develop coping strategies that promote self-esteem and positive body image. In addition, "Ineffective Coping related to chronic illness" should also be considered as a nursing diagnosis. The nurse should assess the child's coping mechanisms and provide interventions that promote effective coping skills. These could include distraction techniques, relaxation exercises, and support groups.
Overall, the nurse should focus on providing comprehensive care that addresses both the physical and emotional needs of the child with atopic dermatitis.
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