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NR 226 Quiz 2

NR 226 Quiz 2

NR 226 Quiz 2

Name

Chamberlain University

NR-226: Fundamentals – Patient Care

Prof. Name

Date

NR 226 Quiz 2

  1. A client experiencing progressive dementia is no longer able to live independently. In a discussion with the client’s only son regarding health care services and potential long-term living arrangements, the nurse will recommend a nursing center, as home care has become unsafe.

  2. The most reliable statement from a client that indicates an understanding of health promotion activities in older adults is: “I still keep my dentist appointments even though I have partials now.”

  3. The primary distinction between delirium and dementia lies in their characteristics. Delirium can lead to symptoms such as hallucinations, agitation, confusion, and memory loss, presenting with a rapid onset usually due to an acute illness. In contrast, dementia progresses gradually and does not affect all older adults; it may arise from various causes. Importantly, delirium can also alter consciousness, which is not the case with dementia.

  4. In caring for older adults with multiple medical conditions, the nurse recognizes that heart disease remains the leading cause of death in this age group.

  5. When addressing a postoperative older adult’s request for pain medication, the nurse understands that cognitively impaired clients may require more careful monitoring of their pain levels.

  6. A young parent expresses concern because their child frequently wakes up screaming while appearing to be deeply asleep. The nurse identifies this behavior as a symptom of night terrors.

  7. A college student visits the University Health Clinic, reporting persistent exhaustion. The nurse identifies sleep deprivation as a common cause of this symptom in young adults.

  8. While educating the family of an older adult about sleep, the nurse notes their concern that daily napping may be affecting their father’s nighttime rest. An appropriate response would be that napping is typical for older adults, but it should ideally be limited to 20-30 minutes.

  9. During REM sleep, cognitive restoration occurs, and vivid dreaming takes place.

  10. When discussing sleep problems with a group of older adults, the nurse can offer several suggestions to improve their sleep quality, including: keeping pets out of the bedroom at night, installing room-darkening curtains, and checking the room temperature.

NR 226 Quiz 2


Table Format

Question NumberQuestion
1A client experiencing worsening dementia can no longer live independently. The nurse will suggest a nursing center, as home care has become unsafe.
2The statement indicating an older adult’s understanding of health promotion is: “I still keep my dentist appointments even though I have partials now.”
3The primary difference between delirium and dementia is that delirium may cause hallucinations, agitation, confusion, and memory loss, with a rapid onset due to acute illness. Dementia is a gradual process that may have various causes and does not impact all older adults. Delirium can alter consciousness, while dementia cannot.
4The leading cause of death for older adults with multiple medical problems is heart disease.
5The nurse understands that cognitively impaired clients may need more careful monitoring regarding pain management.
6A symptom of night terrors is observed when a child wakes up screaming while appearing sound asleep.
7A common cause of exhaustion reported by a college student is sleep deprivation.
8In response to concerns about daily napping, the nurse explains that it is common for older adults but should be limited to 20-30 minutes.
9During REM sleep, cognitive restoration and vivid dreaming occur.
10Suggestions for helping older adults sleep better include keeping pets out of the room at night, using room-darkening curtains, and checking the room temperature.

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NR 226 Quiz 1 https://hireonlineclasshelp.com/nr-226-quiz-1/ Mon, 28 Oct 2024 14:15:30 +0000 https://hireonlineclasshelp.com/?p=4325 NR 226 Quiz 1 Hireonlineclasshelp.com Chamberlain University BSN NR 226 Fundamentals – Patient Care NR 226 Quiz 1 Name Chamberlain University NR-226: Fundamentals – Patient Care Prof. Name Date Question 1 The patient has been prescribed an oral dosage of cephalexin (Keflex) at 325 mg. The medication available is in a concentration of 250 mg […]

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NR 226 Quiz 1

NR 226 Quiz 1

NR 226 Quiz 1

Name

Chamberlain University

NR-226: Fundamentals – Patient Care

Prof. Name

Date

Question 1

The patient has been prescribed an oral dosage of cephalexin (Keflex) at 325 mg. The medication available is in a concentration of 250 mg per 2 mL. To determine the volume (in mL) the nurse should administer, we perform a dimensional analysis. The calculation yields a required dosage of 2.6 mL.

Dimensional Analysis: [ \frac{2 \, \text{mL}}{325 \, \text{mg}} = \frac{250 \, \text{mg}}{250} ] Calculated Volume: 2.6 mL

Question 2

The patient has been ordered to take amoxicillin (Amoxil) at a dosage of 2.4 g orally. The available amoxicillin comes in a concentration of 600 mg per 10 mL. Following a dimensional analysis, the nurse should administer 40 mL.

Dimensional Analysis: [ \frac{10 \, \text{mL}}{1000 \, \text{mg}} = \frac{2.4 \, \text{g}}{24000} ] Calculated Volume: 40 mL

Question 3

For the patient requiring diphenhydramine HCl (Benadryl) at a dose of 37.5 mg orally, the medication available is 12.5 mg per 10 mL. The nurse will need to administer 30 mL based on the dimensional analysis.

Dimensional Analysis: [ \frac{10 \, \text{mL}}{37.5 \, \text{mg}} = \frac{12.5 \, \text{mg}}{12.5} ] Calculated Volume: 30 mL

Question 4

The order for potassium chloride (K-Lor) is 60 mEq orally. The available concentration is 40 mEq per 10 mL. The calculated volume to administer is 15 mL.

Dimensional Analysis: [ \frac{10 \, \text{mL}}{60 \, \text{mEq}} = \frac{40 \, \text{mEq}}{40} ] Calculated Volume: 15 mL

Question 5

The patient requires gabapentin (Neurontin) at 275 mg orally. The available dosage is 250 mg per 10 mL. The nurse should administer 11 mL.

Dimensional Analysis: [ \frac{10 \, \text{mL}}{275 \, \text{mg}} = \frac{250 \, \text{mg}}{250} ] Calculated Volume: 11 mL

Question 6

For a morphine sulfate (Duramorph) order of 60 mg orally, with an available concentration of 20 mg per 10 mL, the nurse should administer 6 tsp.

Dimensional Analysis: [ \frac{1 \, \text{tsp}}{10 \, \text{mL}} = \frac{60 \, \text{mg}}{600} ] Calculated Volume: 6 tsp

Question 7

The order for tolbutemide (Orinase) is 0.5 g orally, with the available formulation being 250 mg per scored tablet. The nurse will administer 2 tablets.

Dimensional Analysis: [ \frac{1 \, \text{tab}}{1000 \, \text{mg}} = \frac{0.5 \, \text{g}}{500} ] Calculated Volume: 2 tabs

Question 8

For potassium chloride (K Dur), the patient requires 50 mEq orally. The available dosage is 20 mEq per scored tablet, thus the nurse should administer 2.5 tablets.

Dimensional Analysis: [ \frac{1 \, \text{tab}}{50 \, \text{mEq}} = \frac{20 \, \text{mEq}}{20} ] Calculated Volume: 2.5 tabs

Question 9

For a metformin (Glucophage) order of 0.5 g orally, with the medication available as 1000 mg per scored tablet, the calculated administration is 0.5 tablets.

Dimensional Analysis: [ \frac{1 \, \text{tab}}{1000 \, \text{mg}} = \frac{0.5 \, \text{g}}{500} ] Calculated Volume: 0.5 tab

Question 10

The order for atorvastatin (Lipitor) is 50 mg orally, and the available medication is 50 mg per tablet. Therefore, the nurse will administer 1 tablet.

Dimensional Analysis: [ \frac{1 \, \text{tab}}{50 \, \text{mg}} = \frac{50 \, \text{mg}}{50} ] Calculated Volume: 1 tab

Question 11

The patient has been prescribed digoxin (Lanoxin) at 625 mcg orally. The available dosage is 0.25 mg per scored tablet, resulting in an administration of 2.5 tablets.

Dimensional Analysis: [ \frac{1 \, \text{tab}}{1 \, \text{mg}} = \frac{625 \, \text{mcg}}{625} ] Calculated Volume: 2.5 tabs

NR 226 Quiz 1

Question 12

The order for hydrochlorothiazide (HydroDIURIL) is 100 mg orally, with the available formulation being 50 mg per scored tablet. The nurse should administer 2 tablets.

Dimensional Analysis: [ \frac{1 \, \text{tab}}{100 \, \text{mg}} = \frac{50 \, \text{mg}}{50} ] Calculated Volume: 2 tabs

Question 13

For the ordered cyclosporine (Neoral) at 4 mg/kg/day, and given the patient’s weight of 162 lb, the nurse will administer 295 mg daily.

Dimensional Analysis: [ 4 \, \text{mg} \times \frac{162 \, \text{lb}}{1 \, \text{kg}} \times \frac{1 \, \text{kg}}{2.2 \, \text{lb}} = 294.5 \text{ (rounded to 295 mg)} ]

Question 14

The patient has been ordered sulfasalazine (Axulfidine) at 0.25 g orally, with the available medication being 250 mg per scored tablet. The nurse will administer 1 tablet.

Dimensional Analysis: [ \frac{1 \, \text{tab}}{1000 \, \text{mg}} = \frac{0.25 \, \text{g}}{250} ] Calculated Volume: 1 tab

Question 15

The order for atropine (AtroPen) is 450 mcg subcutaneously. The available formulation is 0.5 mg per 0.7 mL. The calculated volume for administration is 0.6 mL.

Dimensional Analysis: [ \frac{0.7 \, \text{mL}}{1 \, \text{mg}} = \frac{450 \, \text{mcg}}{315} ] Calculated Volume: 0.6 mL

Question 16

For enoxaparin (Lovenox) at 1 mg/kg subcutaneously, the patient weighs 180 lb. The nurse will administer 0.8 mL.

Dimensional Analysis: [ 1 \, \text{mL} \times \frac{1 \, \text{mg}}{1 \, \text{kg}} \times \frac{180 \, \text{lb}}{2.2 \, \text{lb}} = 0.8 \text{ mL} ]

Question 17

The patient has an order for digoxin (Lanoxin) 0.75 mg IVP. The medication available is 500 mcg/mL. The calculated volume for administration is 1.5 mL.

Dimensional Analysis: [ \frac{1 \, \text{mL}}{1000 \, \text{mcg}} = \frac{0.75 \, \text{mg}}{750} ] Calculated Volume: 1.5 mL

Question 18

The order for cyanocobalamin (Vitamin B12) is 70 mcg subcutaneously, with the available dosage at 0.1 mg/mL. The nurse will administer 0.7 mL.

Dimensional Analysis: [ \frac{1 \, \text{mL}}{1 \, \text{mg}} = \frac{70 \, \text{mcg}}{70} ] Calculated Volume: 0.7 mL

Question 19

For meperidine HCl (Demerol) at 100 mg IM, the available concentration is 75 mg/mL. The nurse should administer 1.3 mL.

Dimensional Analysis: [ \frac{1 \, \text{mL}}{100 \

, \text{mg}} = \frac{100}{75} ] Calculated Volume: 1.3 mL

NR 226 Quiz 1

Question 20

The patient has an order for furosemide (Lasix) at 35 mg IVP, with the medication available as 10 mg/mL. The calculated administration volume is 3.5 mL.

Dimensional Analysis: [ \frac{1 \, \text{mL}}{35 \, \text{mg}} = \frac{35}{10} ] Calculated Volume: 3.5 mL

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NR 226 Exam 3 https://hireonlineclasshelp.com/nr-226-exam-3/ Mon, 28 Oct 2024 14:12:25 +0000 https://hireonlineclasshelp.com/?p=4319 NR 226 Exam 3 Hireonlineclasshelp.com Chamberlain University BSN NR 226 Fundamentals – Patient Care NR 226 Exam3 Name Chamberlain University NR-226: Fundamentals – Patient Care Prof. Name Date NR 226 Fundamentals of Nursing Exam 3 Chapter 21: Managing Care Prioritizing Patient Care Prioritizing patient care is vital for nurses as it enables them to identify […]

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NR 226 Exam 3

NR 226 Exam 3

NR 226 Exam3

Name

Chamberlain University

NR-226: Fundamentals – Patient Care

Prof. Name

Date

NR 226 Fundamentals of Nursing Exam 3

Chapter 21: Managing Care

Prioritizing Patient Care

Prioritizing patient care is vital for nurses as it enables them to identify relationships among various patient problems. This approach helps avoid delays in taking necessary actions that could prevent serious complications. Immediate action is essential to stabilize patients’ conditions, following the ABC rule: airway, breathing, and circulation should always be the top priority.

The categorization of patient care prioritization is as follows:

Priority Level Description Examples
High Emergency situations posing immediate threats to survival or safety. Obstructed airway, anxiety attack
Intermediate Non-emergency but important needs experienced by patients and families. Anticipating patient education on new medications, managing post-operative pain.
Low Issues not directly related to the patient’s current illness, focusing on developmental or long-term health needs. Patient education required before discharge.

Types of Nursing

Nursing models play a significant role in the delivery of care. Various models include:

Nursing Model Description Cons
Primary Nursing A single RN takes responsibility for a patient’s care, with limited patient assignments. Does not necessarily reduce costs; care plans require approval for changes.
Total Patient Care The RN oversees all aspects of patient care, working directly with the patient and healthcare team. High RN demand makes it less cost-effective; communication lapses can affect continuity.
Functional Nursing Care is divided among team members by function. Potential fragmentation of care; may not provide holistic care.
Case Management Coordinates healthcare services to streamline costs and enhance quality. Direct care may not always be provided.
Team Nursing An RN leads a team of RNs, LPNs, and MAs to provide care under supervision. Delegation takes time, and RNs may not have adequate patient contact.

Magnet Hospital

Magnet hospitals are recognized for their clinical promotion systems, research initiatives, and commitment to evidence-based practice. Nurses within these organizations maintain professional autonomy and control over their practice environment. This empowerment fosters innovation and collaborative relationships, ultimately improving the quality of patient care.

Delegation to Medical Assistants and LPNs

Delegation involves transferring the responsibility for a task while retaining accountability for the outcome. Key aspects of delegation include assessing the knowledge and skills of team members and matching tasks appropriately. Effective communication is critical, requiring clear directions, active listening, and feedback. The Five Rights of Delegation include:

Rights of Delegation Description
Task Routine, non-invasive tasks requiring minimal supervision.
Circumstance Appropriate patient settings and available resources.
Person Matching the right person to perform the task and the right person to receive it.
Direction Clear instructions about the task, including objectives and limits.
Supervision Providing ongoing monitoring and support for the delegated task.

Chapter 24: Communication

Communication Techniques for Special Needs

Effective communication is essential, particularly for patients with special needs such as cognitive impairments, hearing loss, or vision loss. Strategies include:

Condition Techniques
Cognitive Impairment Use simple sentences, ask one question at a time, allow response time, and include family in conversations.
Hearing Impaired Reduce noise, gain the patient’s attention before speaking, and ensure visibility of the speaker’s mouth.
Visually Impaired Maintain a normal tone, use indirect lighting, and ensure print size is adequate.
Cannot Speak Listen attentively, ask yes/no questions, and utilize visual aids.

Communication Techniques

Various communication techniques enhance interactions, including:

Technique Description
Parroting Repeating what the patient has said without paraphrasing.
Clarifying Restating unclear questions to ensure understanding.
Focusing Directing the conversation to key elements without interrupting.
Paraphrasing Briefly restating the patient’s message in the nurse’s own words to confirm understanding.

SBAR Communication Method

The SBAR method standardizes communication about significant patient events. It encompasses:

  • Situation: Identify the current issue, including admitting and secondary diagnoses.
  • Background: Provide pertinent medical history and previous treatments.
  • Assessment: Include significant findings from assessments and vital signs.
  • Recommendation: Suggest a plan of care and highlight necessary actions.

Types of Communication

Therapeutic Communication Non-therapeutic Communication
Encourages the expression of feelings and conveys respect. Can hinder professional relationships and block expression.

Zones of Personal Space

Understanding personal space is crucial for patient interactions:

Zone Distance Examples
Intimate 0-18 inches Performing assessments, changing dressings.
Personal 18 inches-4 ft Sitting at a bedside, taking patient history.
Social 4-12 ft Making rounds, teaching classes.
Public 12 ft and greater Speaking at community events, lecturing.

Chapter 50: Care of the Surgical Patient

Surgical Classifications

Surgical procedures are categorized based on urgency and purpose:

Classification Description Examples
Urgent Needed to prevent health deterioration; not emergent. Excision of a cancerous tumor.
Elective Patient choice; not essential for health. Hernia repair.
Emergency Immediate action required to save life or function. Control of internal bleeding.
Major Extensive alterations; higher risk. Coronary artery bypass graft (CABG).
Minor Minimal alterations; low risk. Tooth extraction.
Diagnostic Surgical exploration for diagnosis. Exploratory laparotomy.
Ablative Removal of a body part. Gallbladder removal.
Palliative Relieves symptoms; does not cure. Colostomy.
Reconstructive Restores function or appearance. Scar revision.
Procurement Removal of organs for transplant. Kidney transplant.
Constructive Restores lost function due to congenital issues. Repair of cleft palate.
Cosmetic Improves personal appearance. Rhinoplasty.

Malignant Hyperthermia

Malignant hyperthermia is a life-threatening genetic disorder associated with anesthesia, characterized by symptoms like hypercarbia and muscular rigidity. Close monitoring of temperature is essential, especially when anesthesia is introduced.

Pre-operative Care

In the pre-operative unit, several steps ensure patient readiness for surgery, including:

  • Explaining surgical preparation steps.
  • Reviewing the pre-operative checklist.
  • Assessing physical and mental readiness for surgery.
  • Inserting an IV for fluids if necessary.
  • Monitoring vital signs.
  • Initiating conscious sedation.

Post-Anesthesia Care Unit (PACU)

In the PACU, the following parameters are assessed:

  • Vital signs and respiratory adequacy.
  • Post-operative cardiac status.
  • Pain levels and peripheral circulation.
  • Monitoring for nausea and vomiting.

Types of Anesthesia

Understanding the various types of anesthesia is crucial for managing patient care:

Anesthesia Type Purpose Complications Nursing Implications
General Induces immobility and lack of memory during surgery. Cardiovascular and respiratory depression, organ damage. Monitor vital signs and recovery status.
Regional Loss of sensation in a specific area without loss of consciousness. Sudden drops in blood pressure and impaired breathing. Assess respiratory status and position of limbs.
Local Loss of sensation at a specific site. Limited motor function depending on injection site. Monitor for adverse reactions and functional abilities.
Conscious Sedation Provides sedation while maintaining patient responsiveness. Similar risks as other anesthetics. Ensure airway maintenance and monitor response to stimuli.

Time Out Protocol

The Time Out protocol occurs prior to surgery when all healthcare personnel convene to confirm the surgical plan and patient details, ensuring patient safety.

Roles of the Circulating and Scrub Nurse

The roles in the operating room include:

Circulating Nurse Scrub Nurse
Must be an RN; oversees intraoperative care and documentation. Maintains the sterile field and assists the surgeon.
Evaluates patient care and verifies instrument counts. Assists with draping and instrument handoff.

References

American Nurses Association. (2021). Nursing: Scope and standards of practice. American Nurses Association.

Black, J. M., & Hawks, J. H. (2016). Medical-surgical nursing: Clinical management for positive outcomes. Elsevier.

Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2017). Medical-surgical nursing: Assessment and management of clinical problems. Elsevier.

Potter, P. A., & Perry, A. G. (2022). Fundamentals of nursing. Elsevier.

NR 226 Exam3

Smeltzer, S. C., & Bare, B. G. (2020). Textbook of medical-surgical nursing. Pearson.

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NR 226 Exam 2 https://hireonlineclasshelp.com/nr-226-exam-2/ Mon, 28 Oct 2024 13:54:53 +0000 https://hireonlineclasshelp.com/?p=4313 NR 226 Exam 2 Hireonlineclasshelp.com Chamberlain University BSN NR 226 Fundamentals – Patient Care NR 226 Exam 2 Name Chamberlain University NR-226: Fundamentals – Patient Care Prof. Name Date NR 226: Exam 2 Review Questions A nurse suspects a fluid and electrolyte imbalance in an older adult. Which assessment best indicates fluid and electrolyte balance? […]

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NR 226 Exam 2

NR 226 Exam 2

NR 226 Exam 2

Name

Chamberlain University

NR-226: Fundamentals – Patient Care

Prof. Name

Date

NR 226: Exam 2 Review Questions

  1. A nurse suspects a fluid and electrolyte imbalance in an older adult. Which assessment best indicates fluid and electrolyte balance?

    • a. Intake and output results
    • b. Serum laboratory values
    • c. Condition of the skin
    • d. Presence of tenting
  2. A nurse is caring for a patient with an intestinal stoma. Which intervention is most important?

    • a. Cleansing the stoma with cool water
    • b. Spraying an air-freshening deodorant in the room
    • c. Selecting a bag with an appropriate-size stomal opening
    • d. Wearing sterile nonlatex gloves when caring for the stoma
  3. A nurse is caring for a patient who had an abdominal hysterectomy. Which intervention best prevents postoperative thrombophlebitis (DVT)?

    • a. Utilization of compression stockings at night
    • b. Deep breathing and coughing daily
    • c. Leg exercises 10 times per hour when awake
    • d. Elevation of the legs on 2 pillows
  4. The nurse monitors a client with a nasogastric tube attached to low suction for manifestations of which disorder?

    • a. Metabolic acidosis
    • b. Metabolic alkalosis
    • c. Respiratory acidosis
    • d. Respiratory alkalosis
  5. A client with broken ribs is likely to experience what type of acid-base imbalance?

    • a. Respiratory acidosis from inadequate ventilation
    • b. Respiratory alkalosis from anxiety and hyperventilation
    • c. Metabolic acidosis from calcium loss due to broken bones
    • d. Metabolic alkalosis from taking analgesics containing base products
  6. A patient with diarrhea needs to replace potassium. Which nutrient selections indicate additional teaching on potassium-rich foods is needed? (Select all that apply.)

    • a. Beef bouillon
    • b. Orange juice
    • c. Poached egg
    • d. Warm tea
    • e. Avocado
  7. A 750-mL tap-water enema is ordered for a patient. Which approach best promotes acceptance of the volume?

    • a. Administer the fluid slowly, and have the patient take shallow breaths
    • b. Place the patient in the left lateral position, and slowly administer the fluid
    • c. Have the patient take shallow breaths, and keep the fluid at body temperature
    • d. Keep the fluid at body temperature, and place the patient in the left lateral position
  8. Which information indicates a patient at highest risk for developing diarrhea?

    • a. Is physically active
    • b. Drinks a lot of fluid
    • c. Eats whole-grain bread
    • d. Is experiencing emotional problems
  9. Sequential compression devices (SCD) are ordered for a postoperative patient. Which information should the nurse provide? (Select all that apply.)

    • a. Keeps the lower extremities warm
    • b. Helps prevent deep vein thrombosis
    • c. Accelerates the rate of wound healing
    • d. Promotes circulation of blood back to the heart
    • e. Eliminates the need for leg and foot exercises after surgery
  10. A patient in the post anesthesia care unit (PACU) has vital signs: BP 150/90 mm Hg, pulse 88 (bounding), respirations 24 with crackles. What is the patient likely experiencing?

    • a. Hypoglycemia
    • b. Hyponatremia
    • c. Hyperkalemia
    • d. Hypervolemia
  11. A patient reports no bowel movement in 10 days. Which questions help assess for fecal impaction? (Select all that apply.)

    • a. “How long has it been since you had a formed stool?”
    • b. “Have you had small amounts of liquid stool?”
    • c. “Do you notice a bad odor to your breath?”
    • d. “Have you been eating food with fiber?”
    • e. “Are you having any vomiting?”
  12. A postoperative client becomes restless. What should the nurse do first?

    • a. Notify the physician
    • b. Medicate the patient for pain
    • c. Check the client’s vital signs
    • d. Talk to the client in a calm voice
  13. A client scheduled for surgery expresses uncertainty about proceeding. What is the nurse’s best response?

    • a. “It is your decision.”
    • b. “Do not worry. Everything will be fine.”
    • c. “Why do you not want to have this surgery?”
    • d. “Tell me what concerns you have about the surgery.”
  14. When explaining at-home fecal occult blood testing, which instructions should the nurse include?

    • a. Eating more protein is optimal prior to testing
    • b. Continue all scheduled medications, including aspirin, before the test
    • c. A red color change indicates a positive result
    • d. The specimen must not be contaminated with urine
  15. A nurse assesses a client who has had diarrhea for 4 days. Which findings are expected? (Select all that apply.)

    • a. Bradycardia
    • b. Hypotension
    • c. Elevated temperature
    • d. Poor skin turgor
    • e. Peripheral edema
  16. A client receiving IV therapy reports arm pain, chills, and general malaise, with warmth, edema, and redness near the IV site. What is the nurse’s first action?

    • a. Obtain a specimen for culture
    • b. Apply a warm compress
    • c. Administer analgesics
    • d. Discontinue the infusion
  17. During an admission assessment, which findings would the nurse not expect in a client with hypovolemia due to vomiting and diarrhea? (Select all that apply.)

    • a. Flat neck veins
    • b. Thready pulse
    • c. Syncope
    • d. Dark urine
    • e. Postural hypotension
  18. A client’s potassium level is 5.2 mEq/L. What should the nurse anticipate after notifying the provider?

    • a. Starting an IV infusion of 0.9% sodium chloride
    • b. Consulting with a dietician to increase potassium intake
    • c. Initiating continuous cardiac monitoring
    • d. Preparing the patient for gastric lavage
  19. A nurse assesses a client with a calcium level of 10.8 mEq/L. Which findings are expected? (Select all that apply.)

    • a. Hyperreflexia
    • b. Muscle weakness
    • c. Positive Chvostek’s sign
    • d. Muscle cramps
    • e. Kidney stones

NR 226 Exam 2

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NR 226 Exam 1 https://hireonlineclasshelp.com/nr-226-exam-1/ Mon, 28 Oct 2024 13:40:57 +0000 https://hireonlineclasshelp.com/?p=4307 NR 226 Exam 1 Hireonlineclasshelp.com Chamberlain University BSN NR 226 Fundamentals – Patient Care NR 226 Exam 1 Name Chamberlain University NR-226: Fundamentals – Patient Care Prof. Name Date NR 226 Exam 1 Review Clinical Judgement and Decision-Making Clinical judgement and decision-making in nursing involve assessing patient conditions and making informed choices to enhance health […]

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NR 226 Exam 1

NR 226 Exam 1

NR 226 Exam 1

Name

Chamberlain University

NR-226: Fundamentals – Patient Care

Prof. Name

Date

NR 226 Exam 1 Review

Clinical Judgement and Decision-Making

Clinical judgement and decision-making in nursing involve assessing patient conditions and making informed choices to enhance health outcomes. Nurses utilize critical thinking to select the most suitable interventions, establish priority settings, and ensure patient-centered care. The clinical decision-making process integrates the nursing process, a universal, systematic approach for delivering care. This methodology includes phases of assessment, diagnosis, planning, implementation, and evaluation (ADPIE), each contributing to a comprehensive and evidence-based care approach. During the assessment phase, nurses gather subjective and objective data to form a clear understanding of the patient’s condition. The diagnosis phase focuses on interpreting data to identify health issues, risk factors, and opportunities for health promotion. Planning involves setting measurable, attainable goals for desired outcomes. Nurses implement interventions in the implementation phase and evaluate outcomes in the final phase to assess the effectiveness of interventions and adjust care plans if necessary (American Nurses Association, 2020).

Clinical Judgement Functions within the Nursing Process

Clinical judgement in the nursing process entails six primary functions that guide the nurse in patient care. Recognizing cues, such as symptoms, health history, and environmental factors, is essential in identifying the patient’s clinical presentation. Analyzing cues links these observations to client needs and concerns. Nurses prioritize hypotheses to determine which health issues require immediate attention, often considering lab values, diagnostic tests, and risk assessments. In generating solutions, nurses establish expected outcomes aligned with patient needs and determine the most appropriate interventions. Actions are then taken through the implementation of these planned interventions, and outcomes are evaluated to reach a conclusion on the effectiveness of the care provided. Nurses must continuously adapt and personalize care approaches based on the patient’s response to interventions (Smith & Brown, 2019).

Nursing Process and Interventions

The nursing process encompasses a structured framework to provide consistent care. Nurses employ various types of interventions to address patient needs. Nurse-initiated interventions, or independent actions, include patient education and health promotion activities that do not require provider orders. Health care provider-initiated interventions require a prescription, such as medication administration or surgery preparation. Collaborative interventions involve the input of multiple health care professionals, ensuring comprehensive care that integrates various expertise. Effective implementation involves both direct and indirect care activities, such as infection control and documentation. During the evaluation phase, nurses assess whether the patient’s health goals have been met, identifying any barriers to success and revising care plans as needed to meet the patient’s changing health needs (Johnson, 2022).

Nursing Process Table

Phases of Nursing ProcessKey ActivitiesOutcomes Expected
AssessmentGathering subjective and objective data through patient interaction and observation.Detailed patient information to establish health baseline
DiagnosisInterpreting data to identify health issues, risks, and needs.Clear statement of patient’s health status and priorities
PlanningSetting achievable, measurable goals and selecting interventions.Concrete goals and interventions tailored to patient needs
ImplementationPerforming planned interventions, coordinating care with health teams.Effective interventions aligned with patient care goals
EvaluationAssessing intervention effectiveness and revising care plan as needed.Outcome comparison to goals, guiding ongoing patient care

EVALUATING ACTION PLANS IN NURSING CARE

Standard of Care

Scope of Practice

The scope of practice in nursing encapsulates the values and abilities that nurses bring to patient care. It defines what nurses are authorized to do based on professional standards, healthcare laws, and evidence-based knowledge. State Nurse Practice Acts, the American Nurses Association (ANA), and guidelines from The Joint Commission outline these standards. Additionally, facility policies, procedures, state, and federal laws help shape the practice framework, ensuring that nurses provide quality care within legally defined boundaries (American Nurses Association, 2015).

Informed Consent
Informed consent is fundamental in medical procedures, requiring that patients are informed about potential risks, benefits, alternatives, and consequences if they decline a procedure. While healthcare providers bear the primary responsibility for obtaining informed consent, nurses play a critical role in this process. They witness the consent, verify the patient’s understanding, and ensure proper documentation. Nurses are obligated to report any lack of clarity to the healthcare provider, ensuring that patients make informed decisions (Emanuel et al., 2020).

Negligence and Malpractice

Negligence occurs when a nurse’s actions fall below the accepted standard of care, whereas malpractice, a subset of negligence, involves harm due to professional failure. Essential elements for malpractice consideration include duty to provide care, breach of duty, foreseeability of harm, potential for harm, and actual occurrence of harm. Nurses must be vigilant in upholding the standard of care, taking proactive measures to prevent instances of negligence or malpractice (National Council of State Boards of Nursing, 2018).


AGING AND CARE FOR OLDER ADULTS

Physiological Changes in Aging

Integumentary, Respiratory, and Cardiovascular Systems

Aging impacts various body systems, leading to visible and functional changes. The skin loses elasticity, hair grays, and nail growth slows. In the respiratory system, cough reflexes decrease, and chest rigidity increases, challenging respiratory efficiency. Cardiovascular changes include vessel wall thickening, reduced cardiac output, and increased blood pressure due to vascular rigidity. Recognizing these age-related changes helps healthcare providers tailor interventions to maintain the health and comfort of older adults (World Health Organization, 2019).

Sensory and Cognitive Changes

Age-related sensory changes, such as presbyopia and hearing loss (presbycusis), affect vision and hearing. The decline in taste, smell, and proprioception can impact an older adult’s quality of life and safety. Cognitive impairments, including delirium, dementia, and depression, present unique challenges in care, requiring personalized approaches. Each condition requires specific strategies to ensure safety, prevent further cognitive decline, and improve the patient’s overall well-being (Alzheimer’s Association, 2022).

End-of-Life and Palliative Care

End-of-life care aims to provide comfort and dignity to patients in their final stages of life. Hospice care focuses on palliative rather than curative treatment and involves a multidisciplinary team to manage symptoms effectively. Nurses play an integral role in assisting patients and their families through the decision-making process, providing support, and ensuring respectful, compassionate care that aligns with patients’ wishes (National Hospice and Palliative Care Organization, 2020).

MANAGING GRIEF AND END-OF-LIFE DECISIONS

Grieving Process and Support

Grief and Mourning

Grief is an emotional response to loss, often experienced before or after death. Mourning includes socially and culturally specific practices that help individuals cope with their losses. The Kubler-Ross Grief Cycle outlines five stages—denial, anger, bargaining, depression, and acceptance—that individuals often experience in response to significant loss. Nurses must understand these stages to provide empathetic and supportive care to grieving patients and families (Kubler-Ross & Kessler, 2014).

End-of-Life Decisions

Advanced directives, such as living wills and Do Not Resuscitate (DNR) orders, help guide patient care near the end of life. Nurses are essential in educating patients and families about these documents and ensuring that their wishes are respected. They play a critical role in postmortem care, including facilitating family viewing and coordinating organ or tissue donations when appropriate. Compassionate care in these moments is crucial to supporting families through grief and providing a dignified farewell (American Society of Pain Management Nurses, 2019).

References

  • American Nurses Association. (2015). Nursing: Scope and Standards of Practice (3rd ed.). American Nurses Association.
  • Alzheimer’s Association. (2022). Cognitive health and aging. Retrieved from www.alz.org
  • Emanuel, E. J., Wendler, D., & Grady, C. (2020). What makes clinical research ethical?The Journal of the American Medical Association, 283(20), 2701-2711.
  • Kubler-Ross, E., & Kessler, D. (2014). On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss. Scribner.
  • National Council of State Boards of Nursing. (2018). Professional boundaries in nursing. Retrieved from www.ncsbn.org
  • National Hospice and Palliative Care Organization. (2020). Standards of practice for hospice programs. Retrieved from www.nhpco.org

NR 226 Exam 1

  • American Nurses Association. (2020). Nursing: Scope and Standards of Practice. American Nurses Association.
  • Johnson, M. (2022). Clinical Nursing Skills and Techniques. Elsevier Health Sciences.
  • Smith, R., & Brown, L. (2019). Fundamentals of Nursing: The Art and Science of Person-Centered Care. Lippincott Williams & Wilkins.

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NR 226 RUA Fundamentals Patient Care https://hireonlineclasshelp.com/nr-226-rua-fundamentals-patient-care/ Mon, 28 Oct 2024 13:28:46 +0000 https://hireonlineclasshelp.com/?p=4301 NR 226 RUA Fundamentals Patient Care Hireonlineclasshelp.com Chamberlain University BSN NR 226 Fundamentals – Patient Care NR 226 RUA Fundamentals Patient Care Name Chamberlain University NR-226: Fundamentals – Patient Care Prof. Name Date Assessment Component Description Percussion The patient documentation lacks specific information regarding percussion. Typically, percussion evaluates sounds such as tympani (drum-like) over hollow […]

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NR 226 RUA Fundamentals Patient Care

NR 226 RUA Fundamentals Patient Care

NR 226 RUA Fundamentals Patient Care

Name

Chamberlain University

NR-226: Fundamentals – Patient Care

Prof. Name

Date

Assessment

ComponentDescription
PercussionThe patient documentation lacks specific information regarding percussion. Typically, percussion evaluates sounds such as tympani (drum-like) over hollow organs and dullness (muffled) over solid organs like the liver and spleen.
AuscultationBowel sounds are described as normative, indicating normal frequency and intensity. Breath sounds are clear, with diminished sounds at the lung bases, suggesting reduced air entry in those areas.
Neurological ExamThe patient is oriented to person, place, and time, showing intact cognitive function. A gross assessment of cranial nerves II-XII is intact. Upper extremity reflexes are normal (graded 2+), but lower extremity reflexes are absent, expected in paraplegic cases. Paralysis in lower extremities with no sensation below the T4 dermatome, consistent with spinal cord infarction.

Pathophysiology

ComponentDescription
Functional ChangesDue to the fractured extremity, the patient has a reduced ability to move it, as bone structure and surrounding tissues are compromised. The inflammatory response increases pain and blood flow to the area, possibly causing redness and warmth unless obstructed by fracture type.
Inability to Support the BodyThe T4-T5 fracture prevents the body from bearing weight, impairing walking ability. Nerve disruption affects motor signals, preventing necessary body movement.

Reflection

ComponentDescription
CommunicationEmploying active listening to address D.M.’s concerns and needs, strengthening therapeutic relationships. Non-verbal strategies like eye contact and culturally sensitive communication will be used to respect D.M.’s preferences.
Safety/Infection ControlMeasures for DVT, muscle atrophy, decreased healing, and pressure ulcer prevention will be implemented, along with infection control practices, such as diligent hand hygiene and catheter care. Regular monitoring for signs of infection at the incision site will support optimal recovery.

References

Crawford, A., & Harris, H. (2016). Caring for adults with impaired physical mobility. Nursing, 46(12), 36-41. https://doi.org/10.1097/01.NURSE.0000504674.19099.1d

Santos, C., Almeida, M., & Lucena, A. (2016). The Nursing Diagnosis of risk for pressure ulcer: content validation. Revista Latino-Americana de Enfermagem, 24, e2693. https://doi.org/10.1590/1518-8345.0782.2693

NR 226 RUA Fundamentals Patient Care

Suarni, L., Nurjannah, I., & Apriyani, H. (2015). Nursing and collaborative diagnoses on perioperative with and without using six steps of diagnostic reasoning methods. International Journal of Research in Medical Sciences, 3(Suppl 1), S97-103.

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