What is the most appropriate response to Anita in this situation?
I hear and understand what you are saying. We'll certainly do what we can to
make sure you don't stay any longer than you have to! The provider didn't s
...
What is the most appropriate response to Anita in this situation?
I hear and understand what you are saying. We'll certainly do what we can to
make sure you don't stay any longer than you have to! The provider didn't say
you were ready to be discharged today, but I can bring up your concerns with
him today. In the meantime, why don't we discuss your feelings further?
Why is this the best response to Anita's concern?
This answer reiterates that a nurse is not able to decide if a patient may be
discharged without the input of their provider, although the patient's
perspective should still be heard, acknowledged, and addressed.
The correct answer is:
While your entire healthcare team monitors your progress, ultimately your
provider decides when you may be discharged. This will be when you have
satisfied certain benchmarks, such as using your walker by yourself,
transferring, and going up and down stairs. If we discharged you too soon, it
could put you at risk for another fall. I know you miss home, but your safety is
of the utmost importance.
Why is this the best response to Anita's concern?
This answer provides medical reasoning for why early discharge could
jeopardize patient safety, in addition to correctly representing Toolkit policy.
What is the most appropriate response to Anita's concern?
Continue doing your exercises and following the physical therapist’s
instructions. Eat well, get plenty of rest, and take your medications as
recommended by your provider. It’s great that you’re motivated, but just
remember that pushing too hard and too fast can end up causing damage in
the long-run.
Why is this the best response to Anita's concern?
This answer reiterates the importance of providing education on medical
interventions in order to protect patient safety.
hat is the most appropriate response to Anita in this situation?
Whether you go home or go to a rehabilitation facility is determined by how
much progress you have made toward these benchmarks. Other factors
include your support system, as well as the safety of your home. The provider
will always recommend the option that is best for your health and safety.
Why is this the best response to Anita's concern?
This answer promotes patient safety, while providing accurate information
about discharge.
What is the most appropriate response to Anita's concern?
I’m not at liberty to share another patient’s private health information. Be
assured she is being well cared for.
Why is this the best response to Anita's concern?
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This answer avoids betraying patient confidentiality.
________________Pt.Patel interactions____________
The correct answer is:
You arrived at our hospital with gastroenteritis and were showing signs of
dehydration and confusion. You hadn't been able to keep your diabetes
medication down, which had raised your blood sugar and led to you going into
a hyperosmolar, hyperglycemic state. This means that your body was trying to
expel the excess sugar through your urine, which contributed to your
dehydration. You were treated with IV fluids and insulin to hydrate you and
bring your blood sugar back under control, and you were given promethazine
to soothe your nausea. At this point, your blood sugar has returned to an
acceptable level and your nausea has decreased.
The correct answer is:
The correct selection uses clear language to briefly but thoroughly describe
Mr. Patel's hospital experience. It neither skips over important information
nor relies on jargon.
The correct answer is:
This prescription is for 25 mg of promethazine to be taken twice a day for a
week, as needed, for nausea. If the nausea continues, follow up with your
primary care provider. If you forget a dose, take it immediately unless it's
close to time for the next dose. Never take an extra dose to make up for
missing a dose. If you overdose or show signs of an allergic reaction, get
emergency help immediately. Store the pills at room temperature.
The correct answer is:
The correct selection includes a complete and accurate set of instructions.
The correct answer is:
There are a number of serious adverse effects that can be caused by
promethazine. You should stop using promethazine and seek out emergency
care immediately if you experience severe drowsiness, light-headedness,
confusion, hallucinations, fidgeting and increased irritability, spontaneous
muscle movements, nervous system disorders, sudden weakness or illness,
yellowing of the skin or eyes, increased bruising or bleeding, an increased or
decreased heartbeat, or seizures.
The correct answer is:
You provide Mr. Patel an accurate list of serious adverse effects to look out for
and advise him of what to do if he experiences them.
The correct answer is:
There are some common adverse effects that you may experience while taking
promethazine. These include dizziness, drowsiness, tinnitus, dry mouth,
double vision, and difficulty sleeping. You should avoid alcohol while taking
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promethazine, as it can make some of these effects worse. Since it can make
you drowsy and dizzy, you should be careful if you drive, operate heavy
machinery, or do anything else that requires a quick reaction time.
Promethazine will also make you more susceptible to sunburn, so it's a good
idea to use sunscreen when you go outside.
The correct answer is:
You provide Mr. Patel with a complete, accurate list of promethazine's
common adverse effects and tell him what he should avoid doing while taking
it.
The correct answer is:
Actually, if it is already time for your next dose, you should skip the missed
dose and return to your normal schedule. Aside from that, it seems like you
have a good grasp on how to manage your promethazine.
The correct answer is:
You offer a correction for your patient's error in a respectful and considerate
way.
The correct answer is:
It's a good idea to work with a diabetes educator or a dietitian to develop a
meal plan that works for you and helps you meet your blood glucose target.
One popular diabetic diet is the 1800-calorie, low sugar and low carbohydrate
diet, which can help patients lose weight or stabilize their weight. You should
also try to drink 8 cups of water a day to stay at the appropriate level of
hydration. When it comes to exercise, aerobic exercise can help your body use
insulin, improve blood circulation, lower blood pressure, and lower blood
glucose, while strength training can lower blood glucose and make you more
receptive to insulin. The American Diabetes Association recommends getting
30 minutes of aerobic activity 5 days a week and performing strength training
two times a week. This kind of diet and exercise can lower your risk for
diabetes-related complications, like the HHS for which you were just treated.
The correct answer is:
You make accurate recommendations and explain their importance in a clear
and respectful way, without assigning blame.
The correct answer is:
That's correct! You show a good understanding of the importance of diet and
exercise, and it sounds like you know what you need to do to get started
The correct answer is:
You positively reinforce Mr. Patel's comprehension, without offering
redundant, unnecessary, or insulting feedback
The correct answer is:
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Make sure to check your blood pressure at least one time a day. Check your
glucose once the morning before you eat breakfast and then once later in the
day, 2 hours following any meal. Record the results so that you can bring
them to appointments with your primary care provider. This log can help you
track the effectiveness of your care plan and let you and your provider know
the kinds of changes you will need to make to keep your blood glucose and
blood pressure in a healthy range.
The correct answer is:
You provide comprehensive instructions on when to take blood pressure and
blood sugar readings and explain why it is important to monitor and keep a
record of those readings.
The correct answer is:
It sounds like you have a good grasp of what to do and why it's important. I
know that the finger-prick test is uncomfortable for you, and I'm sorry that it's
so difficult. Keep in mind, though, that maintaining a continual record of your
blood sugar could be an important part of keeping your diabetes under
control without insulin. If you end up on insulin, that could mean more needle
use, or the need to use an insulin pen or jet injector. Now, there are some new
glucose-monitoring products that do not use needles, but if that ends up not
being an option, I strongly recommend that you continue to test your blood
glucose with the finger-prick test.
The correct answer is:
You reiterate the importance of Mr. Patel monitoring his blood glucose,
bringing up a possible negative outcome of not doing so properly, while
responding to his dislike of needles with respect and empathy.
The correct answer is:
You can make this plan with your doctor or a diabetes educator. It should
include when you should call the members of your diabetes care team, how
often you should take your blood sugar and measure your urine ketones, and
what medications you should take. It will also include a description of how to
eat, when and if you can still eat. I recommend that you actually draft up this
plan and keep it in a place that's easy for you to find. You should also keep
critical phone numbers -- for your doctor, your diabetes educator, and your
dietitian -- with the plan, so you don't have to go hunting for them.
The correct answer is:
You explain the concept of a sick-day plan and help Mr. Patel understand how
to start developing one with expert help
The correct answer is:
Having a dietitian and a diabetes educator on your healthcare team can be
really valuable, and I recommend you work with your insurance company to
explore your options. However, if getting these specialists proves to be an
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impossibility, you can still develop a sick-day plan with your primary care
provider.
The correct answer is:
You respond to Mr. Patel's financial concern honestly and with empathy.
The correct answer is:
Make an appointment to follow up with your primary care provider within one
week.
The correct answer is:
You give Mr. Patel a clear, specific instruction with a clear deadline.
While this practice does cut down on liability issues for hospitals, at heart, it's designed
to support patient safety. Many patients, coming off of bedrest and unfamiliar
medications, are at risk for falls at the time of their discharge.
____________ Interactions with Charge Nurse Angel________________
The correct answer is:
We need to clarify who does what aspects of the discharge.
The correct answer is:
This policy addition would help prevent situations where staff members don't
complete tasks that they incorrectly think a different staff member has
claimed.
The correct answer is:
"The nurse in charge of the patient's care will complete all aspects of the
discharge, unless they must delegate certain tasks."
The correct answer is:
It prevents staff members who are not in charge of a patient's care from
executing tasks that the nurse in charge may have already done or delegated
The correct answer is:
"RNs can complete and/or delegate all discharge tasks. LPNs can go over with
patients any educational materials already written by RNs; LPNs can also
wheel patients out of the hospital. UAPs can wheel patients out of the
hospital."
The correct answer is:
The licensure competencies in this case determine what level of involvement
staff can have with discharge education.
The correct answer is:
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