A registered nurse is attempting to change the method for documenting client care in a medical/surgical floor setting. What questions should be considered before planning change? (Select all that apply.)
How can the change be averted?
How cohesive does the group function as a unit?
Is the group as a whole amenable to change?
Is the group ready for change?
Correct Answer : B,C,D
Choice A rationale:
Focuses on avoiding change rather than managing it effectively. Change is often necessary for improvement and growth. Seeking ways to avert it can hinder progress and prevent potential benefits.
Undermines the nurse's role as a change agent. Nurses are expected to play a proactive role in initiating and implementing change to enhance patient care and organizational effectiveness.
May lead to missed opportunities to address issues or challenges. By focusing on averting change, underlying problems may remain unaddressed, potentially compromising patient care or organizational efficiency.
Choice B rationale:
Addresses group cohesion, which is crucial for successful change implementation. Cohesive groups demonstrate better communication, collaboration, and support, facilitating acceptance and adaptation to change.
Recognizes that change can disrupt group dynamics and relationships. Assessing group cohesion allows for identification of potential challenges and development of strategies to strengthen relationships and foster teamwork during the change process.
Highlights the importance of considering the social and relational aspects of change. Change is not only a technical process; it involves individuals with emotions, beliefs, and social connections that need to be considered for successful implementation.
Choice C rationale:
Assesses the group's overall openness and willingness to accept change. Some groups may be more resistant to change due to past experiences, fear of the unknown, or attachment to existing practices.
Determines if the change aligns with the group's values and beliefs. Change that conflicts with deeply held values is likely to encounter stronger resistance and may require additional strategies to address concerns and build consensus.
Recognizes that not all groups are equally adaptable to change. Understanding the group's amenability to change helps in tailoring implementation strategies and managing potential resistance.
Choice D rationale:
Evaluates the group's preparedness for change in terms of knowledge, skills, and resources. Insufficient preparation can lead to confusion, frustration, and decreased effectiveness during the change process.
Considers the group's emotional readiness to accept and adapt to change. Even if a change is technically feasible, emotional resistance can hinder its success. Assessing readiness allows for addressing concerns and providing support to facilitate the transition.
Ensures that the group has the necessary support and resources to implement the change successfully. Change often requires training, guidance, and time for adjustment. Providing adequate support systems is essential for successful implementation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Brown or black urine is not a typical observation associated with Levodopa use. It can indicate other potential causes, such as: Dehydration
Liver disease
Rhabdomyolysis (muscle breakdown)
Certain medications like metronidazole or iron supplements
Hematuria (blood in the urine)
It's essential to rule out these conditions if brown or black urine is observed.
Choice C rationale:
Green or blue-green urine is also not common with Levodopa. It can be caused by:
Medications like amitriptyline, indomethacin, propofol, or methylene blue
Certain food dyes
Urinary tract infections caused by Pseudomonas bacteria
Familial benign hypercalcemia (a rare genetic condition)
Choice D rationale:
Blood-tinged urine (hematuria) is not a direct effect of Levodopa. It can signal underlying urinary tract issues, such as: Infections
Kidney stones
Bladder or kidney tumors
Trauma to the urinary tract
Strenuous exercise
Choice B rationale:
Orange or orange-red urine is the most common observation in patients taking Levodopa. This discoloration is due to: Breakdown of Levodopa into dopamine and other metabolites
These metabolites can impart an orange or reddish hue to the urine
The color intensity may vary depending on dosage and individual metabolism
It's generally harmless and doesn't require medical intervention
However, it's essential to inform healthcare providers about any urine color changes to ensure proper monitoring and rule out other potential causes.
Correct Answer is B
Explanation
Choice A rationale:
Sims' position is a side-lying position with the lower leg flexed and the upper leg extended. It is not ideal for bladder scanning because it can compress the bladder and make it difficult to obtain an accurate reading.
Additionally, in Sims' position, the bladder may not be fully accessible to the scanner, as it may be partially obscured by the upper thigh.
Choice B rationale:
Dorsal recumbent position is the optimal position for bladder scanning. In this position, the client lies flat on their back with their knees bent and their feet flat on the bed. This position allows for:
Full exposure of the bladder, making it easily accessible to the scanner.
Relaxation of the abdominal muscles, which can help to ensure an accurate reading.
A comfortable position for the client, promoting cooperation and reducing the likelihood of movement that could interfere with the scan.
Choice C rationale:
Supine position is a similar position to dorsal recumbent, but with the legs fully extended. While it is possible to perform a bladder scan in this position, it is not as ideal as dorsal recumbent because:
The extended legs can place some tension on the abdominal muscles, potentially affecting bladder position and the scan's accuracy.
The client may find this position less comfortable, leading to restlessness and potential movement that could interfere with the scan.
Choice D rationale:
High Fowler's position is a semi-sitting position with the head of the bed elevated at a 45- to 60-degree angle. This position is not suitable for bladder scanning because:
Gravity can pull the bladder downwards, making it difficult to visualize and measure accurately.
It can be challenging to maintain proper positioning of the scanner on the abdomen in this position, potentially leading to inaccurate readings.
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