What should the nurse do to decrease the patient's disorientation at night during the detoxification period?
Use nightlights and remove extra furniture from the room.
Place the patient in a room with another recovering patient.
Instruct the patient to orient himself to his surroundings at bedtime.
Wake the patient up every 4 hours to eat a small snack.
The Correct Answer is A
A. Use nightlights and remove extra furniture from the room: Nightlights provide gentle lighting that can reduce disorientation, and removing extra furniture minimizes fall risk.
B. Place the patient in a room with another recovering patient. This might increase agitation and disrupt both patients' sleep.
C. Instruct the patient to orient himself to his surroundings at bedtime. This may not be effective due to the patient's disorientation during detoxification.
D. Wake the patient up every 4 hours to eat a small snack. Frequent waking can disrupt sleep patterns and increase confusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is F
Explanation
A. Insert nasogastric tube: A nasogastric tube may be inserted early to prevent aspiration and manage gastric distension.
B. Initiate fluid therapy: Fluid therapy is crucial and initiated early to combat hypovolemic shock.
C. Insert Foley catheter: A Foley catheter is often inserted early to monitor urine output and assess renal function.
D. Establish airway: Establishing an airway is the highest priority intervention for burn victims, especially if there are signs of inhalation injury.
E. Administer analgesics: Pain management is crucial but is initiated early in the treatment process.
F. Tetanus prophylaxis: Tetanus prophylaxis is important to prevent infection but is typically administered after the immediate life-threatening issues have been addressed.
Correct Answer is C
Explanation
A. Conversion: Conversion involves a psychological conflict being expressed as physical symptoms, which does not fit the patient's response.
B. Repression: Repression involves unconsciously blocking out unpleasant thoughts or memories, which is not evident in the patient’s response.
C. Denial: Denial involves refusing to accept reality or facts, which fits the patient’s statement that the candy won’t affect their blood sugar levels.
D. Regression: Regression involves reverting to earlier developmental stages or behaviors, which does not apply to this situation.
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