1.A nurse is caring for a client who Is postoperative and refuses to use an incentive spirometer following major abdominal surgery. Which of the following actions is the nurse’s priority? – Determine the reasons why the
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1.A nurse is caring for a client who Is postoperative and refuses to use an incentive spirometer following major abdominal surgery. Which of the following actions is the nurse’s priority? – Determine the reasons why the client is refusing to use the incentive
spirometer b/c the first action the nurse should take when using the nursing process is to assess the client; therefore, the priority action for the nurse to take is to determine why the client is refusing the treatment.
A nurse is caring for a client who has pharyngeal diphtheria. Which of the following types of transmission precautions should the nurse initiate? –
Droplet b/c droplet precautions are a requirement for clients who have infections that spread via droplet nuclei that are
larger than 5 microns in diameter, including rubella, meningococcal pneumonia, and streptococcal pharyngitis. The nurse should wear a mask when providing care or when within 1 m (3 feet) of the client who has a disorder requiring droplet precautions.
•Lacrimal apparatus – if a client has an impairment in the ability to produce tears, it should not affect their fall risk. The nurse test this by palpating the tear duct at the lower eyelid to see if any tears emerge.
•Appearance of bulbar conjunctivae – the nurse should examine the bulbar conjunctivae by gently retracting the lower and upper lids to evaluate color and texture and assess for the presence of infection. However, the condition of the conjunctivae will not impede the
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