You are caring for a patient who has had a right eye cataract removal. What discharge instruction would you want to include in the plan of care?
Answer(s): A
The patient should not sleep on the right side following surgery. The patient should be placed in a semi-Fowler position to minimize edema and intraocular pressure. The patient should wear glasses and a protective shield over the affected eye.
You have delegated the care of an older patient with hearing loss to a nursing assistant. You tell the nursing assistant that patients with this diagnosis:
Answer(s): B
Older patients with hearing loss respond better to low pitch sounds. Age-related changes of the inner ear are called presbycusis. As a result of these changes the patient often loses the ability to hear high-pitched sounds.
The most appropriate action by the nurse who is preparing to communicate with an older patient who has hearing loss is:
The nurse should stand in front of the patient with hearing loss while trying to communicate with them. By standing in front of the patient and providing adequate lighting, the nurse insures that the patient can see the nurse clearly. If there is still difficulty communicating, then notes and pantomime can be used.
Which of the following assessments would make the nurse suspect that a child has strabismus?
A child with strabismus will tilt head to see. Strabismus is when the extraocular muscles have a lack of coordination so the eyes do not align. The patient may complain of frequent headaches and squint to see and may need to go to surgery to realign the weak muscles if nonsurgical interventions do not work.
You are caring for a child with chlamydial conjunctivitis. What would you want to investigate if you had a patient with this diagnosis?
Answer(s): C
The nurse would want to investigate possible sexual abuse. This diagnosis in a child who is not sexually active should trigger suspicions in the nurse. Allergy, trauma and infection can all cause conjunctivitis, but chlamydia is a sexually transmitted disease.
You are caring for a child who is going to have a tonsillectomy. Which of the following laboratory results would you want to check preoperatively?
The nurse would want to check the prothrombin time preoperatively and report any abnormal results to the surgeon. The tonsillar area is very vascular, which can increase the patient's chance of bleeding. If the prothrombin time is not adequate, the patient could bleed to death.
You are caring for a child who will have a tonsillectomy. Which of the following would increase the child's risk of aspiration during surgery?
If the child has loose teeth it increases the risk of aspiration. A and D are symptoms that indicate the need for surgery. C will be taken care of during surgery with suctioning and packing. Therefore it is important that the nurse check the child for loose teeth prior to surgery to prevent aspiration.
You are caring for the child who has had a tonsillectomy. The physician has written postoperative orders.Which of the following orders would the nurse question?
Answer(s): D
You would not want to suction a patient who just had a tonsillectomy. Suction equipment should be available at bedside in case of airway obstruction. Otherwise, a patient would not be suctioned due to the risk of trauma to the oropharynx. All other orders listed are appropriate for this patient.
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