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Comparing the patient’s current (home) medications with those ordered during hospitalization and communicating a complete list of medications to the next care provider when the patient is transferred within an organization or to another setting a re strategies toward best achieving what patient related goal?
- A. Improving accuracy of patient identification.
- B. Preventing errors related to look-alike and sound-alike medications.
- C. Reconciling medications across the continuum of care.
- D. Reducing harms associated with administration of anti coagulants.
Correct Answer: C
Rationale: Step 1: Reconciling medications is essential for patient safety as it involves comparing current and ordered medications to ensure accuracy.
Step 2: This process helps prevent medication errors, adverse drug reactions, and duplications across different care settings.
Step 3: Communicating a complete list of medications to the next care provider ensures continuity of care and reduces the risk of medication discrepancies.
Step 4: By reconciling medications across the continuum of care, healthcare providers can better coordinate patient care and optimize treatment outcomes.
In summary, choice C is correct as it focuses on medication reconciliation to improve patient safety and care coordination. Choices A, B, and D are incorrect as they do not directly address the comprehensive process of reconciling medications across care settings.
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The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a blood pressure of 90/60 mm Hg, hear t rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value reqaubiirrbe.sco imm/temste diate action by the nurse?
- A. Cardiac index (CI) of 1.2 L/min/m3
- B. Cardiac output (CO) of 4 L/min
- C. Pulmonary vascular resistance (PVR) of 80 dynes/sec/cm5
- D. Systemic vascular resistance (SVR) of 1800 dynes/sec /cm5
Correct Answer: B
Rationale: The correct answer is B: Cardiac output (CO) of 4 L/min. In this scenario, the patient is presenting with signs of pulmonary congestion and hypoxemia, indicating possible cardiogenic pulmonary edema. As the cardiac output is a key indicator of how well the heart is functioning and delivering blood to the body, a low cardiac output can lead to inadequate tissue perfusion and worsen the patient's condition. Therefore, immediate action is required to address the low cardiac output to improve tissue perfusion and oxygenation.
Choices A, C, and D are incorrect as they do not directly address the primary concern of inadequate cardiac output in this patient. Cardiac index, pulmonary vascular resistance, and systemic vascular resistance are important parameters to monitor, but in this case, the priority is to address the low cardiac output to improve the patient's condition.
The nurse is managing a donor patient six hours prior to th e scheduled harvesting of the patient’s organs. Which assessment finding requires imme diate action by the nurse?
- A. Morning serum blood glucose of 128 mg/dL
- B. pH 7.30; PaCO 38 mm Hg; HCO 16 mEq/L 2 3
- C. Pulmonary artery temperature of 97.8° F
- D. Central venous pressure of 8 mm Hg
Correct Answer: B
Rationale: The correct answer is B. The patient's pH of 7.30 indicates acidosis, PaCO2 of 38 mm Hg is low, and HCO3 of 16 mEq/L is also low, suggesting metabolic acidosis. This finding requires immediate action as untreated acidosis can lead to serious complications.
Choice A (morning serum blood glucose of 128 mg/dL) is within normal range and does not require immediate action.
Choice C (pulmonary artery temperature of 97.8°F) is a normal temperature and does not require immediate action.
Choice D (central venous pressure of 8 mm Hg) is within normal range and does not require immediate action.
A new nurse has recently joined the ICU from a different hospital, which had a much stricter policy regarding visiting hours. She expresses concern about the impact of open visiting hours on patient well-being. Which of the following would be the best explanation for the purpose of open visiting hours? Select all that apply.
- A. To better provide rest and quiet
- B. To strengthen the relationship between the family and health care provider
- C. To control the number of visitors for a patient
- D. To provide an undisturbed environment
Correct Answer: B
Rationale: The correct answer is B: To strengthen the relationship between the family and health care provider.
Rationale:
1. Open visiting hours encourage family involvement in care, fostering a partnership between healthcare providers and families.
2. Family support can positively impact patient outcomes and satisfaction.
3. It allows families to be updated on the patient's condition and involved in decision-making.
4. Strengthening the relationship can lead to better communication and trust between all parties.
Summary of Incorrect Choices:
A: Open visiting hours may disrupt rest and quiet, but the primary purpose is not to provide rest.
C: Open visiting hours do not aim to control the number of visitors but rather encourage family involvement.
D: While open visiting hours may not provide an entirely undisturbed environment, the focus is on improving family-provider relationships.
Which statement reflects adherence to current recommendations concerning open visitation policies?
- A. Allowing animals on the unit; however, these can only be “therapy” animals through the hospital’s pet therapy program.
- B. Allowing family visitation throughout the day except a t change of shift and during rounds.
- C. Determining, in collaboration with the patient and famaiblyirb, .cwomho/te csta n visit and when.
- D. Permitting open visitation by adults 18 years of age and older; limit visits of children to 1 hour.
Correct Answer: C
Rationale: The correct answer is C because it reflects patient-centered care by involving patients and families in decision-making. Collaborating with them on visitation preferences promotes a supportive environment. Choice A restricts animal visitation, not addressing human visitors. Choice B limits visitation during specific times, not individualized. Choice D imposes restrictions based on age, not on patient/family preferences. Therefore, Choice C is the most aligned with current recommendations for open visitation policies.
A patient with end-stage heart failure is experiencing consaibdirebr.caobmle/te dsty spnea. What is the appropriate pharmacological management of this symptom ?
- A. Administration of 6 mg of midazolam and initiation of a continuous midazolam infusion.
- B. Administration of morphine, 5 mg IV bolus, and initia tion of a continuous morphine infusion.
- C. Hourly increases of the midazolam (Versed) infusion b y 100% dose increments.
- D. Hourly increases of the morphine infusion by 100% dose increments.
Correct Answer: B
Rationale: The correct answer is B: Administration of morphine, 5 mg IV bolus, and initiation of a continuous morphine infusion. Morphine is the preferred pharmacological management for severe dyspnea in end-stage heart failure due to its potent analgesic and anxiolytic properties.
Step-by-step rationale:
1. Morphine is a potent opioid that helps relieve dyspnea by reducing anxiety, decreasing respiratory drive, and improving overall comfort.
2. The initial IV bolus of 5 mg provides rapid relief of dyspnea.
3. Initiating a continuous morphine infusion ensures sustained relief of dyspnea.
4. Midazolam (choice A) is a benzodiazepine used for sedation and anxiety, but it is not the first-line treatment for dyspnea in this scenario.
5. Increasing the midazolam (choice C) or morphine (choice D) infusions by 100% dose increments hourly is not appropriate as