Which is the priority action by the nurse when a patient discloses a medication allergy during the health history before a surgical procedure?
Verifying the information with the patient's family members at the bedside
Placing an alert bracelet on the patient before leaving the unit
Asking the patient to describe the reaction that occurs
Documenting the information on the patient's medical record
The Correct Answer is C
A. Verifying the information with the patient's family members at the bedside: While family members can provide insight, the most critical step is gathering information directly from the patient about the reaction.
B. Placing an alert bracelet on the patient before leaving the unit: While this is necessary, the nurse should first confirm the details of the allergy.
C. Asking the patient to describe the reaction that occurs: The nurse must determine whether the reaction is a true allergy (e.g., anaphylaxis, rash, difficulty breathing) or an intolerance (e.g., nausea, drowsiness). This ensures appropriate precautions are taken.
D. Documenting the information on the patient's medical record: Documentation is crucial but should follow verification of the allergy details.
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Related Questions
Correct Answer is D
Explanation
A. Employer. An employer is not a unique patient identifier.
B. Medical record number. A medical record number is a unique identifier and is a recommended method for verifying the right patient.
C. Maiden name. A maiden name is not a reliable identifier, as patients may change names over time.
D. Date of birth: The date of birth is a critical and commonly used patient identifier, often paired with another piece of information (such as name or medical record number). It is specific and unique to the patient, making it ideal for ensuring the right individual receives care.
Correct Answer is C
Explanation
A. Circulating nurse: The circulating nurse ensures that the time-out occurs but does not mark the surgical site.
B. Patient's primary nurse: The primary nurse is responsible for preoperative care but does not mark the site.
C. Surgeon: The surgeon performing the procedure is responsible for marking the surgical site to ensure accuracy and prevent wrong-site surgery.
D. Surgical technician: Surgical technicians assist with instruments and procedures but do not mark the surgical site.
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