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The nurse is a member of a committee to design a critical care unit in a new building. Which design trend would best be implemented to facilitate famil y-centered care?
- A. Ensuring that the patient’s room is large enough to inc lude a sleeper sofa and storage for family members’ personal belongings.
- B. Including a diagnostic suite in close proximity to the u nit so that the patient does not have to travel far for testing.
- C. Incorporating a large waiting room on the top floor of athbierb .hcooms/pteistta l with a scenic view and amenities such as coffee and tea.
- D. Providing access to a scenic garden for meditation.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Family-centered care promotes involvement of family members in patient care.
2. A sleeper sofa in the patient's room allows family members to stay overnight, enhancing support for the patient.
3. Storage for personal belongings ensures families can have essentials close by, increasing comfort and convenience.
4. These design elements facilitate family presence, communication, and participation in care, aligning with family-centered care principles.
Summary of Incorrect Choices:
B. Having a diagnostic suite nearby is convenient but not directly related to family-centered care principles.
C. A waiting room with amenities is beneficial but does not directly involve families in patient care.
D. Access to a garden for meditation is helpful for relaxation but does not emphasize family involvement in care.
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The family of a critically ill patient has asked to discuss organ donation with the patient’s nurse. When preparing to answer the family’s questions, th e nurse understands which concern(s) most often influence a family’s decision to donate? (Select all that apply.)
- A. Donor disfigurement influences on funeral care
- B. Fear of inferior medical care provided to donor
- C. Age and location of all possible organ recipients
- D. Concern that donated organs will not be used
Correct Answer: A
Rationale: Rationale for Correct Answer A: Donor disfigurement influences on funeral care. Families often consider the impact of organ donation on the appearance of their loved one during funeral arrangements. This concern can significantly influence their decision to donate.
Incorrect Answers:
B: Fear of inferior medical care provided to donor. This is not a common concern as medical care for donors is typically of high quality.
C: Age and location of all possible organ recipients. While important, this is not a primary concern for families when deciding on organ donation.
D: Concern that donated organs will not be used. Families are generally more concerned about the impact on their loved one's appearance post-donation rather than the utilization of organs.
As part of nursing management of a critically ill patient, o rders are written to keep the head of the bed elevated at 30 degrees, awaken the patient from se dation each morning to assess readiness to wean from mechanical ventilation, and implement oral care protocols every 4 hours. These interventions are done as a group to reduce thabei rrbi.csokm o/tef svt entilator-associated pneumonia. This group of evidence-based interventions is often referred to using what term?
- A. Bundle of care.
- B. Clinical practice guideline.
- C. Patient safety goal.
- D. Quality improvement initiative.
Correct Answer: A
Rationale: The correct answer is A: Bundle of care. A bundle of care refers to a set of evidence-based interventions that, when implemented together, have been shown to improve patient outcomes. In this scenario, keeping the head of the bed elevated, daily awakening from sedation, and oral care protocols are bundled together to reduce the risk of ventilator-associated pneumonia. This approach is based on the idea that implementing multiple interventions simultaneously is more effective than individual interventions alone.
Choices B, C, and D are incorrect because:
B: Clinical practice guidelines provide recommendations for healthcare providers based on evidence but do not necessarily involve a group of interventions bundled together.
C: Patient safety goals are specific objectives aimed at improving patient safety outcomes, but they do not specifically refer to a group of interventions bundled together.
D: Quality improvement initiatives focus on improving processes and outcomes in healthcare settings but do not necessarily involve a group of interventions bundled together for a specific purpose like in this case.
An elderly patient is admitted to the ICU with stage IV lung cancer, diabetes mellitus, and congestive heart failure. The health care team assembled to care for her is large and diverse, including an oncologist, a pulmonologist, an endocrinologist, a cardiologist, and others. The patient is not expected to survive more than a few weeks, and her husband is overwhelmed with stress and grief. Which nurse competency or competencies are most needed in this situation? Select all that apply.
- A. Clinical judgment
- B. Caring practices
- C. Collaboration
- D. Response to diversity
Correct Answer: B
Rationale: The correct answer is B: Caring practices. In this situation, the patient and her husband are dealing with complex medical conditions and emotional distress. Caring practices involve providing compassionate, empathetic, and supportive care to the patient and her family members during this difficult time. The nurse needs to show sensitivity, understanding, and emotional support to help them cope with their situation. Clinical judgment (A) is important but not the primary focus in this scenario. Collaboration (C) is essential in the interdisciplinary team, but caring practices take precedence in addressing the emotional needs. Response to diversity (D) is also important, but in this case, the focus is more on providing compassionate care rather than addressing cultural or social diversity issues.
Many critically ill patients experience anxiety. The nurse can reduce anxiety with which approach?
- A. Asking family members to limit their visitation to 2-hour periods in morning, afternoon, and evening. You know that this is the best approach to ensure uninterrupted rest time for the patient. Tell the patient, “Your family is in the waiting room. They will be permitted to come in at 2:0 0 PM after you take a short nap.”
- B. Explaining the unit routine. “Assessments are done every 4 hours; patients are bathed on the night shift around 5:00 AM; family memabbierbr.sc oamr/ete spt ermitted to visit you after the physicians make their morning rounds. They can spend the day. Lights are out every night at 10:00 PM.”
- C. Stating, “It’s time to turn you. I am going to ask another nurse to come in and help me. We will turn you to your left side. During the turn , I’m going to inspect the skin on your back and rub some lotion on your back. T his should help to make you feel better.”
- D. Suctioning the endotracheal tube immediately when thaeb iprba.ctoiemn/tte sst tarts to cough. Sharing, “Your tube needs suctioned; you should feel better after I’m done.”
Correct Answer: C
Rationale: The correct answer is C because it addresses the patient's anxiety by providing clear communication and involving the patient in the care process. By explaining the turning procedure, inspecting the skin, and providing comfort through lotion application, the nurse establishes trust and promotes a sense of control for the patient. This approach helps alleviate anxiety by keeping the patient informed and engaged in their care.
Choice A is incorrect because limiting family visitation may not directly address the patient's anxiety. Choice B is incorrect as it focuses on routine information rather than directly addressing the patient's anxiety. Choice D is incorrect because suctioning the endotracheal tube may cause discomfort and does not address the underlying anxiety issue.
The nurse assesses a patient who is admitted for an overdo se of sedatives. The nurse expects to find which acid-base alteration?
- A. Hyperventilation and respiratory acidosis
- B. Hypoventilation and respiratory acidosis
- C. Hypoventilation and respiratory alkalosis
- D. Respiratory acidosis and normal oxygen levels
Correct Answer: B
Rationale: The correct answer is B: Hypoventilation and respiratory acidosis. When a patient overdoses on sedatives, it can lead to respiratory depression causing hypoventilation. Hypoventilation results in retention of CO2, leading to respiratory acidosis. This is because the body is not effectively exhaling CO2, causing an increase in carbonic acid levels and a decrease in blood pH. The other choices are incorrect because hyperventilation would lead to respiratory alkalosis (Choice A), hypoventilation does not cause respiratory alkalosis (Choice C), and normal oxygen levels do not indicate the acid-base imbalance caused by sedative overdose (Choice D).