A nurse working on a medical-surgical unit is managing the care of four clients. The nurse should schedule an interdisciplinary conference for which of the following clients?
A client who has Type 1 diabetes and uses an insulin pump
A client who is at risk for pressure ulcers and has an albumin level of 4.2 g/dl
A client who is receiving heparin and has an aPTT of 34 seconds
A client who has orthostatic hypotension and is receiving IV fluids
The Correct Answer is B
A. Management of Type 1 diabetes with an insulin pump usually involves ongoing monitoring and adjustments but may not necessarily warrant an immediate interdisciplinary conference.
B. This client has a notable risk for pressure ulcers due to the albumin level, necessitating an interdisciplinary approach to prevent or manage these ulcers.
C. While monitoring heparin therapy is crucial, an aPTT of 34 seconds is within the therapeutic range and may not require an urgent interdisciplinary conference.
D. Orthostatic hypotension being managed with IV fluids may need ongoing assessment, but it may not warrant an immediate interdisciplinary conference.
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Related Questions
Correct Answer is B
Explanation
A: Providing a 10-minute rest period prior to meals can be beneficial for some clients, but it is not specifically related to the prevention of aspiration in clients with dysphagia. Rest periods do not directly facilitate safer swallowing processes.
B: Elevating the head of the client's bed to 30° during mealtime is the correct technique for a client with dysphagia. This position helps prevent aspiration, which can occur if food or liquids enter the lungs instead of going down the esophagus. The semi-upright position aids in the proper alignment of the esophagus and reduces the risk of choking.
C: Withholding fluids until the end of the meal is not an appropriate technique for a client with dysphagia. Fluids are often needed to help swallow and clear the mouth of food particles. Additionally, providing fluids throughout the meal can help prevent dehydration.
D: Instructing the client to place her chin toward her chest when swallowing can help prevent aspiration in clients with dysphagia. However, this technique should be used in conjunction with other methods, such as the correct positioning of the bed, to ensure safety and effectiveness.
Correct Answer is D
Explanation
A. Referring the adult child to the primary care provider might not immediately address the information needed.
B. Directing the adult child to speak solely with the mother might not be the most helpful approach to gather necessary information.
C. Inviting the adult child to specify what information they seek is not correct as they would have to get this information from their mother or their mother wil have to consent.
D. It is the role of the nurse to inform the child that they cannot disclose that information since patient confidentiality is a priority.
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