A nurse is visiting with the family of a client who has just died. Which of the following actions should the nurse take to promote comfort for the family?
Allow the family as much time as they want with the client.
Use paper tape to hold the client's eyelids open.
Place the client in a supine position.
Avoid repeating information about the client's death.
The Correct Answer is A
A. Allowing the family as much time as they want with the client is essential for them to process their emotions, say goodbye, and find closure. This respects their grieving process and allows
them to spend precious moments with their loved one.
B. Using paper tape to hold the client's eyelids open is not appropriate and may cause discomfort or distress to the family.
C. Placing the client in a supine position is unnecessary after death and may not contribute to the family's comfort.
D. Avoiding repeating information about the client's death is not advisable. The nurse should be available to provide clarification, answer questions, and offer support as needed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Amniotic fluid color: While the color of amniotic fluid can provide important information about fetal well-being and possible complications, the priority immediately following an amniotomy is to assess the fetal heart rate to ensure fetal well-being and monitor for any signs of fetal distress.
B. The client's temperature: While maternal temperature should be monitored regularly during labor to detect signs of infection, it is not the priority immediately following an amniotomy. Fetal well-being takes precedence.
C. Frequency of contractions: Monitoring the frequency of contractions is important for assessing progress in labor and identifying any abnormalities, but it is not the priority immediately following an amniotomy. Fetal well-being should be assessed first.
D. Fetal heart rate: Following an amniotomy, the priority is to assess the fetal heart rate to ensure that the umbilical cord has not prolapsed and that the fetus is not experiencing distress due to changes in amniotic fluid volume or other factors related to the amniotomy. Monitoring fetal heart rate allows for early detection of any signs of fetal distress and prompt intervention if needed.
Correct Answer is E,D,C,B,A
Explanation
E: The first step is to turn off the IV infusion pump and clamp the IV tubing to prevent air from entering the line and to stop the flow of medication or fluids.
D: Next, allowing the preschooler to assist with removing the transparent dressing can help in reducing anxiety and providing a sense of control, which is important for a child's emotional well-being during medical procedures.
B: Applying firm pressure at the IV site after the catheter is removed helps to prevent bleeding and ensures the closure of the venipuncture site.
C: Removing the IV catheter while keeping the catheter hub parallel to the insertion site minimizes discomfort and the risk of damaging the vein.
A: Finally, inspecting the IV catheter tip after removal is essential to ensure that the entire catheter has been removed and that no part has been left in the vein.
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