A nurse is caring for a client who has bipolar disorder and is experiencing acute mania. Thenurse obtained a verbal prescription for restraints. Which of
... [Show More] the following should the actions thenurse
take?
Request a renewal of the prescription every 8 hr. Check the client’s peripheral pulse rate every 30 min Obtain a prescription for restraint within 4 hr. Document the client’s condition every 15 minutes
A nursing planning care for a school-age child who is 4 hr postoperative following perforated appendicitis. Which of the following actions should the nurse include in the plan ofcare? Offer small amounts of clear liquids 6 hr following surgery (assess for gag reflex first) Give cromolyn nebulizer solution every 6 hr (for asthma) Apply a warm compress to the operative site every 4 hr
Administer analgesics on a scheduled basis for the first 24 hr
A nurse is receiving change-of-shift report for a group of clients. Which of the followingclients should the nurse plan to assess first?
A client who has sinus arrhythmia and is receiving cardiac monitoring A client who has diabetes mellitus and a hemoglobin A1C of 6.8% A client who has epidural analgesia and weakness in the lower extremities A client who has a hip fracture and a new onset of tachypnea
A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the nurse tak e?
Shave hairy areas of skin prior to application (apply to hairless, clean & dry areas to promote absorption; avoid oily or broken skin) Wear gloves to apply the patch to the client’s skin
Apply the patch within 1 hr of removing it from the protective pouch (apply immediately) Remove the previous patch and place it in a tissue (fold patch in half with sticky sides pressed together)
A nurse has just received change-of-shift report for four clients. Which of the followingclients should the nurse assess first? A client who was just given a glass of orange juice for a low blood glucose level A client who is schedule for a procedure in 1 hr (can wait)
A client who has 100 mL fluid remaining in his IV bag (can wait)
A client who received a pain medication 30 min ago for postoperative pain A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which ofthe following places the client at risk for aspiration? [Show Less]