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In a critical care unit:
- A nurse is assigned to care for 2 clients
- The nurse performs complete care for the clients
Which type of nursing care delivery system is being employed?
Answer:
TOTAL PATIENT CARE/ PRIVATE DUTY MODEL
Explanation
Total patient care/ private duty model involves having a nurse perform total and complete care for a group of clients on a one-on-one basis. This type nursing care delivery enhances continuity of care.
FeedbackThe unit manager:
- Prepares the unit budget for the upcoming month
- Completes the work schedule of the staff nurses for the next 6 weeks
Which type of manager is being described?
Answer
MIDDLE MANAGER
Explanation
Middle managers supervise staff, prepare budgets and work schedules. Additional tasks include formulation and implementation of policies concerning client care and overall unit operation. Unit managers and supervisors are examples of roles under middle management.
Assessment findings on a 9-year-old include:
- Maculo-papular rash on the scalp and trunk, extremities, and oral mucous membrane
- Fever
- Malaise
- Anorexia
The clinical manifestations are consistent with what infectious disorder?
Answer :
VARICELLA (CHICKENPOX)
Explanation
Varicella (Chickenpox) is caused by Varicella Zoster Virus. It is transmitted via airborne, droplet and direct contact.
Assessment:
Initial symptoms: fever, malaise, anorexia; macular rash on the scalp and trunk → extremities → oral mucous membranes and genital/ rectal areas; papular rash → vesicles → break open → crusts
Assessment:
Implement airborne and contact precautions, at home, isolate the child until the vesicles have crusted and dried, promote skin care: avoid scratching pruritic lesions, bathe, and change clothes daily, apply topical antihistamines; administer medications
Medications:
Acetaminophen for fever, acyclovir (for immunocompromised clients); immunization with varicella vaccine for prevention, varicella zoster immune globulin (VZIG)
Complications:
Pneumonia, secondary bacterial infections, acute postinfectious cerebellar ataxia, encephalitis, Reye syndrome, herpes zoster, hepatitis, retinitis, optic neuritis, varicella zoster arteriopathy
The following infant response was observed when:
- The nurse used the thumb to touch the ball of the newborn’s foot
- The infant’s toes curl down tightly
Which infant/primitive reflex has been assessed?
Answer :
PLANTAR REFLEX
Explanation
The plantar reflex is assessed by using the thumb to touch the ball of the newborn’s foot. As a response, the infant’s toes curl down tightly. The reflex begins at birth and disappears at 8-10 months.
Assessment:
Normal response: infant’s toes curl down tightly
Interventions:
Use the thumb to touch the ball of the newborn’s foot; then observe for normal response; if response is abnormal, notify the health care provider
The nurse conducts an admission assessment on a 75-year-old female newly admitted in the long-term care facility:
- gradual memory loss
- difficulty accomplishing tasks such as cleaning the house and gardening
- confused with time or place
- irritable and agitated
- misplaces things and unable to retrace steps
- needs assistance with activities of daily living
- has wandered twice in the past month
The nurse prepares to implement interventions focused on addressing what type of disorder?
Answer :
Dementia
Explanation
Dementia is a general term used to describe cognitive impairments that have gradual and progressive onset; it affects judgment, cognition, abstract thinking, and social behavior. The disorder is irreversible and results in self-care deficit.
Alzheimer’s disease is the most common form of dementia. It is an irreversible form of senile dementia caused by nerve cell deterioration.
Assessment :
Disorientation, impaired judgment, abstract thinking and learning; impaired recent and remote memory; labile affect (personality and mood changes); agnosia; aphasia, amnesia; apraxia; difficulty performing usual tasks
Interventions :
Conduct a functional assessment (cognitive status, daily functions, medical conditions, behavioral and psychological status); provide cognitive stimulation using simple activities; manager wandering behaviors; provide a consistent environment and structured routines; identify and reinforce retained routines; implement prescribed therapies: review of life therapy, validation therapy, milieu therapy, reality orientation; administer prescribed medications: donepezil, memantine, anti-anxiety drugs, SSRIs
A client with carbon monoxide poisoning exhibits:
- A 5-inch-deep laceration in the right arm
- A scheduled laceration repair
Which type of anesthesia is indicated?
Answer
LOCAL ANESTHESIA
Explanation
Local anesthesia is administered in a specific area for minor surgical procedures. Local anesthetics act by anesthetizing the skin, subcutaneous tissue, and peripheral nerves. The duration of its action can range from 30 minutes to 12 hours or more
Indications:
Anesthetize a specific area for minor surgical procedures
Nursing Care:
Assess for signs of irritation; avoid the use of epinephrine on fingers à vasoconstriction à necrosis; monitor for signs of local irritation
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