The nurse is caring for a 6-year-old patient in the emergency department who just had a full left leg cast placed for a fracture. As the nurse is
... [Show More] reviewing the discharge instructions with the patient's mother, she states, "You don't have to go over those—I'll read them at home." What should the nurse do?
a. Contact the physician immediately.
b. Consider the possibility of health literacy limitations and assess further.
c. Stop the teaching, because the mother obviously has taken care of casts before.
d. Explain to the mother that reading the instructions with her is required. - b. Consider the possibility of health literacy limitations and assess further.
A patient's mother may have limited reading skills or health literacy and should be further assessed. Contacting the physician in this situation would not be appropriate because ensuring that the patient and family understand discharge instructions is the responsibility of the nurse. Assuming that the mother has taken care of casts in the past may be inaccurate. Stating that reading the instructions with the nurse is a requirement does not ensure that the patient or mother comprehends the instructions.
A 58-year-old man is admitted for a small-bowel obstruction late Saturday night. The admitting orders include the need to place a nasogastric (NG) tube to low intermittent suction. During the assessment, the nurse determines that the patient does not speak English. Which action should the nurse take first before placing the NG tube?
a. Use two additional staff members when placing the tube so the patient can be restrained if needed.
b. Request an interpreter per facility protocol.
c. Do not place the NG tube because the physician would not want to frighten the patient.
d. Document the inability to place the NG tube due to lack of ability to communicate. - b. Request an interpreter per facility protocol.
An interpreter employed by the hospital would be the best choice so that someone in the room can communicate and provide comfort for the patient. Taking additional staff into the room may increase the patient's anxiety, thereby decreasing his ability to comprehend the instructions. Although the physician would not want to frighten the patient, the physician ordered the nasogastric (NG) tube for the benefit of the patient; therefore, it needs to be placed. Documenting the inability to place the NG tube due to lack of means of communication is not acceptable and does not ensure that the patient gets the needed treatment.
Which nursing diagnoses are used in developing a patient teaching plan? (Select all that apply.)
a. Moral Distress
b. Lack of Knowledge
c. Difficulty Coping
d. Teaching about Disease
e. Anxiety - b
Lack of Knowledge and Literacy Problem are appropriate nursing diagnoses for use in developing a patient teaching plan. Moral Distress is a nursing diagnosis for those facing ethical decisions. Difficulty Coping is not a nursing diagnosis used in developing a teaching plan, but if a patient is not coping effectively, it may affect the ability to learn. A nursing diagnosis of Anxiety may affect the patient's ability to learn but is not directly related to developing a teaching plan. Teaching about Disease is not a nursing diagnosis. It is an intervention performed by the nurse. [Show Less]