In some cases, patients with osteomalacia may benefit from taking vitamin D, calcium, or phosphate supplements.
What should the nurse advise patients to do in order to support bone health?Nurses should evaluate the patient's understanding of osteoporosis and educate the patient about dietary intake, exercise, and other factors like increasing calcium and vitamin D intake, identifying foods high in calcium, and limiting sodas or colas, which are typically high in phosphorus.
How does the skeletal system respond to osteomalacia?The term "osteomalacia" refers to a condition in which bones become brittle and brittle. They are therefore more brittle than usual and can bend and break more easily. Lack of vitamin D is the most frequent cause. Children that have this illness are said to have rickets.
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a client recently experienced a stroke with accompanying left-sided paralysis. his family voices concerns about how to best interact with him. they report the client doesn't seem aware of their presence when they approach him on his left side. what advice should the nurse give the family? wuizlet
The nurse should advise the family that-
the patient is unaware of his left side, so they should approach him on the right side.
What causes paralysis in one side of body?An injury to the spinal cord or brain that results in hemiplegia causes paralysis on one side of the body. It results in muscle stiffness, weakness, and issues with control. The location and severity of the injury affect how severe the hemiplegia symptoms are.
Is hemiplegia permanent?There is currently no treatment for hemiplegia, which is a permanent condition. The disease is referred to as non-progressive because the symptoms don't worsen with time.
If a person with hemiplegia receives effective treatment, their hemiplegia symptoms may eventually get better. Mobility aids can help people with hemiplegia lead independent, productive lives.
What are the communication difficulties faced by left-brain stroked patients?Those who have survived a left-brain stroke may have difficulty speaking and may lose use of their right side due to paralysis. Communication issues may impair the survivor's capacity for understanding or for expressing themselves (getting the words out). Aphasia is the term for this. They might also have "dysarthria," which is slurred speech caused by weakness in the right side of the face and/or mouth.
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when assessing a patient diagnosed with a mood disorder, which abnormal diagnostic tests would be considered a possible factor in the manifestation of the disorder? select all that apply
RBC (red blood cell), TSH (thyroid stimulating hormone), Blood glucose tests would be considered.
What is a mood disorder?
Mood disorders are psychological disorders that are characterized by elevation or lowering of an individual’s mood. For example bipolar disorder, depression, etc.
When a person has a mood disorder, their general emotional state/ mood is usually distorted, or inconsistent with their circumstances and often interferes with their ability to function.
The 5 major mood disorders are as follows:
Major depressionBipolar disorderDysthymia (dysthymic disorder)Mood disorders due to medical conditionsSubstance-induced mood disorderThe most common mood disorder is depression. In depression, a person is often sad all the time, they lose interest in important parts of their life, their mood fluctuates between extreme sadness and extreme happiness.
So, RBC (red blood cell), TSH (thyroid stimulating hormone), Blood glucose tests would be considered when assessing a patient diagnosed with a mood disorder.
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for continuity of care, ambulatory care providers are more likely than providers of acute care services to rely on the documentation found in the
The documents included in the problem list will be used by those who provide acute care services.
Does being ambulatory imply being able to walk?A patient enters the operating room and leaves after an ambulatory operation. Ambulatory denotes the ability to walk or something associated with it. Ambulance, which is really a mobile hospital, comes to mind when you hear the word "ambulatory."
What separates ambulatory people from those who are not?The self-reported capacity to walk 150 feet, one block, and one flight of stairs was used to determine whether a patient was considered ambulatory or non-ambulatory. Patients were divided into two categories: ambulatory (those who could execute all the activities) and non-ambulatory (those who could perform none of the activities).
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the nurse is providing education about the use of vitamins and minerals at a community health center. one of the participants who is a vegetarian asks if he is at risk for any deficiencies. the nurse identifies which deficiency of which substance as the most common nutritional deficiency in vegetarians?
vitamin B12 is the most common nutritional deficiency in vegetarians.
What is vitamin B12?
Vitamin B₁₂, also known as cobalamin, is a water-soluble vitamin involved in metabolism. It is one of eight B vitamins. It is required by animals, which use it as a cofactor in DNA synthesis, in both fatty acid and amino acid metabolism. Vitamin B12 is required for the formation of red blood cells as well as DNA. Additionally, it plays a significant role in the growth and operation of brain and nerve cells. The protein in the foods we eat forms a bond with vitamin B12. Vitamin B12 becomes free vitamin in the stomach when enzymes and hydrochloric acid break its bond. Inadequate dietary intake of vitamin B12 might lead to a vitamin B12 shortage in some individuals. People who regularly eat meat, fish, and dairy products normally get enough vitamin B12 in their diets, but those who don't can develop deficiencies. Eat more animal items like meat, fish, dairy, and eggs if you want to increase your intake of vitamin B12.
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the nurse is administering an intermittent infusion of an antibiotic to a client whose intravenous (iv) access is an antecubital saline lock. after the nurse opens the roller clamp on the iv tubing, the alarm on the infusion pump indicates an obstruction. what action should the nurse take first?
After the nurse opens the roller clamp on the IV tubing, the alarm on the infusion pump indicates an obstruction, so the nurse should reposition the client's arm.
If the client's elbow is bent, the IV is also unable to infuse, leading to an obstruction alarm, that the nurse ought to 1st arrange to reposition the client's arm to alleviate any obstruction.
A roller clamp is designed to keep up at a prescribed rate the rate of flow of a fluid that flows through a tube. The roller clamp includes a tube winding shaft half around that a fluid flow tube is passed and that prevents the setting of the rate of flow being disturbed if the tube is subject to a balance force.
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an older adult client has been diagnosed with type 2 diabetes and has been prescribed dapagliflozin. which teaching by the nurse is appropriate based on the administration of dapagliflozin?
Dapagliflozin is used to decrease blood sugar levels in persons with type 2 diabetes together with diet, exercise, and perhaps additional drugs (condition in which blood sugar is too high because the body does not produce or use insulin normally).
How should this medicine be used?
Adults with type 2 diabetes, heart disease, blood vessel disease, or several risk factors for developing heart and blood vessel disease are also treated with it to lower their likelihood of having to be hospitalized for heart failure.
Dapagliflozin is available as an oral tablet. It is typically taken once day, with or without food. Take dapagliflozin every day at about the same time. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Take dapagliflozin as prescribed by your doctor. Never take it in larger or less amounts or more frequently than directed by your doctor.
If necessary, your doctor may start you on a low dose of dapagliflozin and then increase it.
Although it does not treat your illness, dapagliflozin aids in controlling it. Dapagliflozin should be taken even if you feel fine. Don't stop taking dapagliflozin without consulting a doctor first.
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A common radiologic diagnostic manifestation of fibrotic restrictive disease is the appearance of.
A common radiologic diagnostic manifestation of fibrotic restrictive disease is the appearance of : a honeycomb lung.
What is a honeycomb lung?In pathology, the term "honeycomb lung" describes the distinctive appearance of cysts of various sizes on a background of heavily scarred lung tissue.
Microscopically, there are expanded airspaces with fibrosis around them and hyperplastic or bronchiolar type epithelium.
Pathologically, honeycombing is caused by the breakdown of alveolar walls, which results in the emergence of sporadic, fibrous-lined airspaces. A fibrotic lung in its last stages is represented by honeycombing.
There is no remedy. Drugs may slow the formation of scar tissue and maintain lung function. Staying active and receiving oxygen therapy may help with symptoms.
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which substance can cause life-threatening dysrhythmias when inhaled? select all that apply. one, some, or all responses may be correct.
Inhaling a substance like prosciutto, salami, spanish chorizo, or pepperoni might result in dysrhythmias that are life-threatening.
The following meats are cured meats:The majority of cured and processed meats come in ready-to-eat forms. Cooked ham, sausages, bacon, and bologna are a few examples of these goods. Bacteria cannot grow when curing salts with nitrate, nitrate, sodium chloride, phosphates, extracts, and flavorings are added.
What do raw and cured meats consist of?The term "cured meat" is frequently used to describe meat-based food preparations, whether they are cooked or raw, where the flavor is increased with salt and other seasonings.
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a nurse is reviewing the dietary history of a client who has experienced anaphylaxis. what would the nurse identify as a common cause of anaphylaxis? select all that apply.
A nurse is looking over a client's dietary history who has had anaphylaxis and is reviewing milk, eggs, and shrimp.
What happens during anaphylaxis?Anaphylaxis, commonly referred to as anaphylactic or anaphylactic shock, is a quick, severe, and occasionally fatal allergic reaction it affects the whole body. The reaction narrows the airways, making it difficult to breathe. The airway may become blocked by severe neck edema.
Which symptoms manifest in anaphylactic shock first?The early warning signs of an anaphylactic reaction may include runny nose , skin rashes, which seem to be frequent allergy symptoms. However, within 30 minutes, additional concerning symptoms start to emerge. These include wheezing, chest discomfort, itching, severe pain, as well as coughing, and there are frequently multiples of each.
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which safety instructions should the nurse provide to the client using hot or cold for pain relief? select all that apply.
Heat boosts the flow of blood and nutrients to an area of the body Cold slows blood flow, reducing swelling and pain.
What should be evaluated before giving out painkillers?
In order to evaluate whether or not a pain medication was effective in terms of a decrease in the patient's degree of pain, the level of pain should be assessed both before and after the medicine has been delivered.
What are the three categories for analgesics, and which ones apply to you?
Analgesic drugs fall into one of three basic categories: Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, dipyrone, and other non-opioid analgesics are examples of non-opioid analgesics. Adjuvant analgesics are a diverse class of medications with primary indications.
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a 68-year-old black man presents to your office with urinary frequency, hesitancy, and nocturia. digital rectal exam reveals asymmetric areas of induration and nodules. which lab finding is most consistent with the diagnosis?
Elevated serum prostate specific antigen is the most consistent lab finding.
What is the reason for elevated serum prostate-specific antigen?
Prostate cancer is the second most common cancer among men to be diagnosed in the US, right behind skin cancer. Male African-Americans are more likely to acquire prostate cancer than white males, and the risk rises with age. It is unusual in guys under the age of fifty. Family history of prostate cancer, smoking, and an animal-fat-rich diet are all risk factors. A digital rectal exam (DRE) or an elevated serum level of prostate-specific antigen are the two most common ways that people with prostate cancer are identified (PSA). Men with risk factors or troubling physical exam results on the DRE should start a workup that includes a serum PSA assessment. Biopsy is used to make diagnoses.
Hence, the answer is Elevated serum prostate specific antigen.
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a patient is admitted to the hospital after not having had a bowel movement in several days. the nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. what complication can this patient develop related to this problem?
The complications the patient can develop are Adhesions, hernias, and neoplasms.
What is Bowel obstruction?
An intestinal obstruction occurs when something obstructs your intestine. Food and faeces may be unable to move freely. When your intestine is functioning normally, digested food travels from your stomach to your rectum. Along the way, your body breaks down food into usable components and converts the remainder to faeces (stool).
It's a common misconception that if you have a bowel obstruction, you can't have a bowel movement. Even if they have a bowel obstruction, some people pass stool. Pain, bloating, and nausea are common symptoms. Even if you have loose stools, you may still have a bowel obstruction.
By increasing the pressure inside your bowels, air or fluid enemas can help clear blockages. For people who are too sick for surgery, a mesh tube known as a stent is a safe alternative. It is inserted into your intestine by your doctor in order to force the bowel open.
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the client's neurologic baseline is alert and oriented with clear, appropriate speech. which nursing action is most appropriate?
Answer:
Obtain a prescription for a blood specimen.
Explanation:
a client has received an unsealed radioactive isotope for treatment of thyroid cancer. which instruction is essential for the nurse to provide the client
RAI radioactive isotope therapy preparation Thyroid-stimulating hormone (TSH) or thyrotropin levels must be high for RAI therapy to be most effective.
What negative consequences might radiation have on thyroid cancer?Severe weariness is one of the most frequent side effects of external radiation for thyroid cancer (fatigue)
swallowing issues
oral aridity
Cough.
Hoarseness.
appetite loss.
reduced blood counts.
Nausea.
After my initial radiation treatment, what should I anticipate?Fatigue (feeling tired) and skin changes are the most frequent early adverse effects. Other early side effects typically have something to do with the area being treated, such as hair loss and mouth issues when radiation treatment is given to this area. The onset of late negative effects can be months or even years away.
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a client with paget's disease comes to the hospital and reports difficulty urinating. the emergency department health care provider consults urology. what should the nurse suspect is the most likely cause of the client's urination problem?
The client who reports paget's disease experience orange urine attributes the coloring to phenazopyridine hydrochloride.
Paget's disease experience Orange to amber-colored urine can be the result of concentrated urine, which can also be brought on by dehydration, fever, bile, an excessive amount of bilirubin or carotene, and the medications nitrofurantoin and phenazopyridine hydrochloride. Urine that ranges from yellow to milky white might be infectious. When used with phenytoin, urine turned pink to scarlet. Metronidazole-exposed urine will change from brown to black in color. Phenazopyridine is used to treat the pain, burning, and discomfort that come from an infected or irritated urinary tract. It is not an antibiotic, so it won't be able to treat the illness. In the US, phenazopyridine can only be obtained with a doctor's prescription.
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velma takes headache medicine to relieve pain. the medicine serves to remove the pain. this is an example of
Velma takes headache medicine to relieve pain and the medicine serves to remove the pain, hence this is an example of : reinforcement.
What do you understand by reinforcement?Consequence that follows an operant response that increases the likelihood of that response occurring in the future is called reinforcement.
Two types of reinforcement are: positive reinforcement that is adding a factor to increase behavior and negative reinforcement that is removing a factor to increase behavior.
A psychological principle suggesting that behaviors are shaped by their consequences, and that individual behaviors can be changed through reinforcement, punishment and extinction is called reinforcement theory .
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8. the nurse obtains the following information about a patient before administration of metformin (glucophage). which finding indicates a need to contact the health care provider before giving the metformin?
Before administering metformin to the patient, whose blood glucose level is 166 mg/dL, a physician must be contacted.
What do they mean when they say they themselves?The English word "patient" is derived from the Latin verb "patiens," which meant to bear with or endure. This phrase is used to describe a patient who is incredibly compliant, who endures the necessary discomfort, and who puts up with the interventions of the outside expert.
What is a patient person?We have a chance to develop patience because it entails learning to wait patiently in the face of discomfort or difficulty, which is present almost everywhere. However, patience may be the key to a happy existence.
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what action should the practical nurse implement to faciliate speech for a client who has fenestrated tra
Tell the client that he is not alone while holding his hand.
What does the anatomy term "fenestrated" mean?The capillaries known as fenestrated capillaries have little pores or apertures. Windows are referred to as "fenestrae" in Latin. Larger molecules and proteins can enter organs and glands through "windows" in fenestrated capillaries.
What does biological fenestration mean?Any small aperture or pore is referred to as a fenestra (fenestration; plural: fenestrations or fenestrae), a term that is frequently used in biological sciences. It is a term that is used in several professions to denote a pore in an anatomical structure. It is the Latin word for "window."
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while caring for a client admitted with a clostridium difficile infection, the nurse notes that the client has had three loose bowel movements in 3 hours. what would be the most appropriate nursing diagnosis to address this health problem?
while caring for a client admitted with a clostridium difficile infection After using the restroom, ask the patient to wash their hands.Make sure everyone involved in patient care washes their hands both before and after each interaction.
Clean the space and the tools with a disinfectant.Only administer antibiotics to patients if necessary.Contact Precautions entail: o Patients with clostridium. diff should, whenever feasible, have a separate room or only share a room with another C. diff patient. o When caring for patients with C, healthcare professionals will don gloves and a gown over their attire. Due to Clostridium difficile's high transmissibility and broad environmental contamination, it's possible that spores could spread through the air. The following are the most typical symptoms and indicators of a mild to moderate C. difficile infection: three or more times per day for more than one day with watery diarrhea. mild abdominal discomfort and cramping until at least 48 hours after your diarrhea stops, remain in your home.
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the world health organization monitors outbreaks of disease all over the world. they study the progression of the outbreak and provide instructions and warnings to help manage and contain them. as an analyst at the who, scarlett collects numbers of avian flu infections in humans. in looking over her spreadsheet, where would scarlett most likely find the highest number of avian flu infections?
As an analyst at the world health organization, she will find the highest number of avian flu infections in Egypt.
Avian flu infection is the strains of the contagion virus that primarily infect birds, however can even infect humans. It can even be passed from person to person.Symptoms begin among 2 to eight days and may appear to be the common grippe. Cough, fever, raw throat, muscle aches, headache and shortness of breath could occur.
The illness will carry a high mortality in humans. Some antiviral medication, if taken among 2 days of symptoms, may help. Egypt has been the foremost affected country within the EMR wherever the illness has remained endemic, with frequent epidemic and 167 human cases that embrace sixty deaths.
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the nurse is caring for a client receiving octreotide for the treatment of acromegaly. the nurse should emphasize the need for what form of baseline and periodic testing?
The client being cared for by the nurse is being treated for acromegaly with octreotide. The nurse should be clear about the type of baseline that is required.
Which one would be applied to determine adrenal function?Test to Stimulate the ACTH The most accurate test for identifying adrenal insufficiency is this one. Before and after an injection of synthetic adrenocorticotrophic hormone (ACTH), a hormone released from the anterior pituitary, blood cortisol levels are assessed.
What factors are taken into account when diagnosing primary adrenal insufficiency?To establish a primary diagnosis of adrenal insufficiency, patients should have a blood test to evaluate their levels of adrenocorticotropic hormone (ACTH), the hormone that instructs the adrenal glands to make cortisol.
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daniel smith is a 44-year-old man who was diagnosed with adhd-inattentive subtype in college, but has not taken medication for the last several years. he is seeking treatment now because of declining work performance following a promotion 7 months ago. specifically, he complains of difficulty finishing papers and staying focused during meetings and fears that his boss is losing confidence in him. assessment confirms a diagnosis of adhd-inattentive subtype. after 2 months treatment on a therapeutic dose of a long-acting stimulant, he states that his focus, sustained attention, and distractibility are much better, but that he still can't get organized and that it takes him longer to complete tasks than it should. would it be appropriate for the pmhnp to raise the dose of the stimulant to address his residual symptoms?
Incorrect. drug reaction Studies on stimulant drugs indicate that the best dosage varies across people and is partly dependent on the function domain.
What exactly does "diagnose" mean?Take note of the pronunciation. the process of determining an illness, ailment, or damage based on its symptoms and indicators. Making a diagnosis may involve using a physical examination, medical history, and procedures such blood tests, imaging studies, and biopsies.
Meaning had a diagnosis?The ailment or issue that someone or something has is identified if that person or thing has been diagnosed with it. Upon diagnosis, a condition or issue is recognized. Flu was identified as the troops' condition.
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a nurse is teaching a group of clients about health promotion activities and lifestyle changes. a client tells the nurse he has smoked two packs of cigarettes a day for the last 4 years and has been told he is at risk for developing respiratory infections. the best response would be:
Quitting smoking is beneficial for your health. The addictive substance in tobacco that is found in cigarettes is nicotine which makes quitting difficult . Several people report withdrawal symptoms like:
1. Anger
2. Anxiety
3. Cravings
4. A downbeat attitude;
5. frustration;
6. a hard time focusing;
7. headaches;
8. insomnia;
9. irritability;
10. restlessness;and
11. weight gain.
To help reduce these symptoms, a number of nicotine replacement therapies are available. They are nicotine gum, gum patches, nasal sprays, inhalers, lozenges, and lozenges.
A few pointers:
• Avoidance. Avoid smoking and areas where you could be tempted to smoke.
• Activities. Exercise or engage in hand-occupied hobbies.
• Alternatives. Use oral replacements like carrot sticks, hard candies, and sugar-free gum.
• A shift in habits. For instance, if you typically smoke during lunch breaks, take a stroll instead.
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The beck depression inventory is to ________ as the thematic apperception test is to ________.
The beck depression inventory is to self report measure as thematic apperception test is to projective test.
What do you mean by Beck Depression Inventory?The Beck Depression Inventory (BDI) is a 21-item self-report scale that assesses key symptoms of mood, pessimism, failure, self-dissatisfaction, self-blame and crying, irritability, social withdrawal, indecision, body image changes, insomnia, fatigue, weight loss, body obsession.
BDI is widely used to screen for depression and also measure behavioral symptoms and depression severity.
Thematic Perception Test helps in revealing patient's dominant motivations, emotions and core personality conflicts. It has a series of 20 cards depicting people with different interpersonal relationships and that are intentionally designed to be ambiguous.
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the nurse is counseling a client who wants to become pregnant. the client tells the nurse that she has a 36-day menstrual cycle and the first day of her last menstrual period was january 8. which date accurately reflects the calculation of the client's next fertile period?
The date that accurately reflects the calculation of the client's next fertile period is January 29 to 30.
What is a menstrual cycle?The menstrual cycle is a series of natural changes in hormone production and the structures of the female reproductive system's uterus and ovaries that allow for pregnancy. The ovarian cycle is in charge of egg production and release, as well as the cyclic release of estrogen and progesterone.
This client's next period will begin 36 days after the first day of her last menstrual period. Her next period starts on February 12. Ovulation happens 14 days before the first day of menstruation. The client can anticipate ovulation between January 29 and 30.
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a telehealth nurse is talking with a client who has a history of right-sided heart failure. the nurse should question the client about which assessment finding that would indicate the client's condition is worsening?
Weight gain will worsen the condition. Right-sided heart failure occurs when the right ventricle of your heart is unable to adequately pump blood to the lungs.
Blood accumulates in your veins, the blood arteries that return blood to the heart from the body. Your veins' pressure rises as a result of this accumulation. One kind of heart failure is right-sided heart failure. Right ventricular (RV) heart failure or right heart failure are other names for right-sided heart failure.
The right side of your heart pumps the "used" blood from your body back to your lungs, where it is replaced with oxygen. Right-sided heart failure occurs when the right ventricle of your heart is unable to adequately pump blood to the lungs. Your veins, which transport blood from the body back to the heart, get clogged with blood over time.
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you suspect that your friend may have internal bleeding. he is unconscious. you phone 9-1-1. what should be your next step?
A sort of sudden unconsciousness called fainting may only last a few seconds. Other kinds have a substantially longer lifespan.
If they still don't answer, take the following actions in that order:
Make that their airway is clear and not showing any symptoms of obstruction, such as laborious or high-pitched breathing.
Check for breathing indications.
Do a pulse or heartbeat check.
Next, make a call to emergency medical services or have someone else do it.
Whether the subject is breathing
Ask the person basic inquiries, such as their name and birthday or the date, if they appear to be awake but appear confused.
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a client is experiencing intertrigo caused by friction between the inner thighs. which action should the nurse take to help this client?
A hernia is described as the body's organ or fatty tissue expanding or pushing through. The weak spot in the muscle or connective tissue pulls outwards.
Why is connective tissue necessary?
tissue that supports, protects, and gives structure to other human tissues and organs. Connective tissue serves to store fat and repair damaged tissue in addition to assisting in the movement of nutrients and other substances between tissues and organs. Connective tissue is made up of cells, fibers, and a gel-like material.
What causes problems with connective tissue?
Connective tissue disorders frequently have unknown causes. Some disorders can be brought on by trauma, while others have a genetic component. Others appear to appear mysteriously. In some circumstances, an
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the nurse is caring for a newborn whose mother was prescribed an opioid analgesic throughout pregnancy. which action would the nurse include in the plan of care?
Preterm, stillbirth, maternal deaths, or neonatal abstinence syndrome have all been related to opioid use disorder in pregnancy as major health effects for expectant mothers and developing newborns.
What negative effects does the newborn experience from the mother's narcotic analgesia?They might make you feel queasy, sick, or sleepy.These medications may impair the newborn's respiration and make them sleepy, which may make it difficult for them to successfully nurse for the first time.
What typical side effects of opiate agonist are there?Sedation, dizziness, vomiting, vomiting, diarrhea, dependence, tolerance, and respiratory failure are common side effects of opioid treatment.Constipation is the most prevalent negative impact of opiate usage.
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the nurse is monitoring a client with continuous pulse oximetry. what action(s) by the nurse are important to obtain accurate results? select all that apply.
Following abdominal surgery, the nurse is using a pulse oximeter to check the client's oxygen saturation to make sure they are receiving enough oxygen.
What would the nurse take to guarantee that the pulse oximeter reading was accurate?Justification: The accuracy of the pulse oximeter value is ensured by comparing the data to the patient's heart rate. The heart rate shown by the pulse oximeter should match the patient's ECG reading or palpated heart rate.
Why is precision crucial in nursing?A rater's assessment of the correspondence between a diagnostic statement and patient data is used to define the accuracy of nurses' diagnoses. Low accuracy can result in time and effort loss, patient injury, the absence of favorable results, and dissatisfaction on the part of the patient and their families.
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