18. The nurse is caring for a patient supported with a ventilator who has been unresponsive since arrival via ambulance 8 days ago. The patient has not been identified, and no family members have been found. The nurse is concerned about the plan of care regarding maintenance or withdrawal of life support measures. Place the steps the nurse will use to resolve this ethical dilemma in the correct order.
1. The nurse identifies possible
solutions or actions to resolve the dilemma.
2. The nurse reviews the medical record, including entries by all health care disciplines, to gather information relevant to this patient's situation.
3. Health care providers use negotiation to redefine the patient's plan of care.
4. The nurse evaluates the plan and revises it with input from other health care providers as necessary.
5. The nurse examines the issue to clarify opinions, values, and facts.
6. The nurse states the
problem.
a. 6, 1, 2, 5, 4, 3
b. 5, 6, 2, 3, 4, 1
c. 1, 2, 5, 4, 3, 6
d. 2, 5, 6, 1, 3, 4
-Turning off the television in the client's room
-Distracting the client with an offer to get a snack
-Reviewing the client's medications for possible interactions
-Monitoring the client's temperature for a fever
Physical causes of agitation, confusion, and combative behavior include drug interaction, drug side effects, temperature elevation [fever], hypoglycemia, hypoxia, and electrolyte imbalances. Reducing stimulation, diversionary approaches, offering as-needed medications, verbal interventions or asking the client for cooperation, and active listening are considered before using seclusion and restraint.
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d. Caregiver
As a caregiver, the nurse helps the client and her or his family set goals. The nurse also assists them in meeting these goals with a minimal financial cost, time, and energy. The educator role is used to explain concepts and facts about health, describe the reason for routine care activities, demonstrate procedures such as self-care activities, reinforce learning or client behavior, and evaluate the client's progress in learning. The advocator role helps protect the client's human and legal rights and provides assistance in asserting these rights if the need arises. In the manager role, the nurse coordinates the activities of members of the nursing staff and has personnel, policy, and budgetary responsibility for a specific nursing unit or agency.
c. Candida albicans
White patchy plaques on the oral mucosa would most likely be a result of C. albicans, a yeast-like fungal infection. This condition is also known as " thrush." Cytomegalovirus may cause a serious viral infection in persons with human immunodeficiency virus [HIV], resulting in retinal, gastrointestinal, and pulmonary manifestations. Histoplasmosis is an infection caused by inhalation of spores of the fungus Histoplasma capsulatum and is characterized by fever, malaise, cough, and lymphadenopathy. Human papillomavirus typically manifests as warts on the hands and feet, as well as mucous membrane lesions of the oral, anal, and genital cavities. It may be transmitted without the presence of warts through body fluids, with some forms associated with cancerous and precancerous conditions.
a. Focus of nursing is caring through the environment
d. Oriented toward providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition
e. Focuses on helping the client deal with the symptoms and changes in function related to an
illness
Nightingale's theory of nursing focuses on nursing by caring through the environment. Nightingale's theory is oriented toward providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition. Nightingale's theory focuses on helping the client deal with the symptoms and changes in function related to an illness. Nightingale's theory does not limit nursing to the administration of medications and treatment. Nightingale's theory suggests that nurses do not need to know all about the disease process, which differentiates nursing from medicine.
c. Increased blood pressure and decreased cardiac output
With aging, narrowing of the arteries causes some increase in the systolic and diastolic blood pressures. Decreases occur in diastolic pressure, diastolic filling, and beta-adrenergic stimulation; increases occur in arterial pressure, systolic pressure, wave velocity, and left ventricular end diastolic pressure. Decreased cardiac output and cardiac reserve decrease the older adult's response to stress. Changes in libido may occur. Testosterone appears to influence the frequency of nocturnal erections; however, low testosterone levels do not affect erections produced by erotic stimuli. There is a loss of skin elasticity. By the age of 60, gastric secretions decrease 70% to 80% of those of the average adult. A decrease in pepsin may hinder protein digestion. There may be a decrease in subcutaneous fat and decreasing body warmth. Some swallowing difficulties occur because older people are susceptible to fluid loss and electrolyte imbalance. This results from decreased thirst sensation, difficulty swallowing, chronic disease, reduced kidney function, diminished cognition, or adverse medication reactions.