Nokea
The nurse is preparing to care for the mother of a preterm infant. When should the nurse plan to begin discharge planning?
- A. When the mother is in labor
- B. When the discharge date is set
- C. After stabilization of the infant during the early stages of hospitalization
- D. When the parents feel comfortable with and can demonstrate adequate care of the infant
Correct Answer: C
Rationale: Discharge planning begins at admission of the preterm infant. The determination of the services, needs, supplies, and equipment requirements should not be made on the day of discharge. Beginning planning during labor is incorrect because the outcome of the delivery is not known. At discharge or when the parents feel comfortable caring for their infant are incorrect because these times are much too late to make the plans that need to be made.
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A client is being discharged from the hospital after a bronchoscopy that was performed a day earlier. After the discharge teaching, the client makes the following statements to the nurse. Which statement should the nurse identify as indicating a need for further teaching?
- A. I will stop smoking my cigarettes.
- B. I can expect to cough up bright red blood.
- C. I will get help immediately if I start having trouble breathing.
- D. I will use the throat lozenges as directed by my doctor until my sore throat goes away.
Correct Answer: B
Rationale: After bronchoscopy, expectorated secretions are inspected for hemoptysis, and if the client expectorates bright red blood, the primary health care provider is to be notified. The client needs to avoid smoking. The client should be observed for signs/symptoms of respiratory distress, including dyspnea, changes in respiratory rate, the use of accessory muscles, and changes in or absent lung sounds. A sore throat is common, and lozenges would be helpful to alleviate it.
The nurse provides instructions regarding home care to a parent of a 3-year-old child who has been hospitalized with hemophilia. Which statement by the parent indicates the need for further teaching?
- A. I should not leave my child unattended.
- B. I need to pad table corners in my home.
- C. My child should not have any immunizations.
- D. I need to remove household items that can tip over.
Correct Answer: C
Rationale: Immunizations are important for children with hemophilia to prevent infections, and the parent's statement about avoiding them indicates a misunderstanding. Not leaving the child unattended, padding table corners, and removing tippable items are appropriate safety measures to prevent bleeding injuries.
The nurse is planning discharge teaching for the parents of a child who sustained a head injury and who is now receiving tapering doses of dexamethasone. The nurse plans to make which statement to the parents?
- A. This medication decreases the chance of infection.
- B. This medication will be discontinued after two doses.
- C. If your child's face becomes puffy, the medication dose needs to be increased.
- D. This medication is tapered to decrease the chance of recurring swelling in the brain.
Correct Answer: D
Rationale: Dexamethasone sodium phosphate is a corticosteroid. The rebounding of cerebral edema is a side effect of dexamethasone sodium phosphate withdrawal if it is done abruptly. This medication decreases inflammation rather than infection. Facial edema is a common side effect that disappears when the medication is discontinued.
The nurse has taught the client with pleurisy about measures to promote comfort during recuperation. The nurse determines that the client has understood the information if the client states the need to follow which instruction?
- A. Try to take only small, shallow breaths.
- B. Take as much pain medication as possible.
- C. Lie on the affected side as much as possible.
- D. Splint the chest wall during coughing and deep breathing.
Correct Answer: D
Rationale: The client with pleurisy should splint the chest wall during coughing and deep breathing. Taking small, shallow breaths promotes atelectasis. The client should take medication cautiously so that adequate coughing and deep breathing are performed and an adequate level of comfort is maintained. The client may also lie on the affected side to minimize the movement of the affected chest wall.
The nurse is teaching a newly diagnosed client about Crohn's disease. The nurse understands which barriers may prevent effective client learning? Select all that apply.
- A. language barriers
- B. motivation to learn
- C. lack of a support system
- D. adequate financial resources
- E. cognitive dysfunction, such as schizophrenia
Correct Answer: A,B,C,E
Rationale: Language barriers, low motivation, lack of support, and cognitive dysfunction hinder learning. Adequate finances are not a barrier.