Which key elements are included in decentralized decision making? (Select all that apply)

Choice A reason: This is an incorrect choice because a patient with chronic viral conjunctivitis would not benefit from the use of lubricant eye ointment. Conjunctivitis is an inflammation of the conjunctiva, which is the thin membrane that covers the white part of the eye and the inner surface of the eyelid. Viral conjunctivitis is caused by a virus, such as adenovirus or herpes simplex virus, and it can cause redness, itching, burning, tearing, or discharge in the eye. Lubricant eye ointment is a thick, greasy substance that can moisturize and protect the eye, but it can also trap the virus and worsen the infection. The patient with viral conjunctivitis should use artificial tears or saline drops instead, and avoid sharing towels, cosmetics, or eye drops with others.

Choice B reason: This is the correct choice because a stroke patient whose right eye does not close fully would benefit from the use of lubricant eye ointment. A stroke is a sudden interruption of blood flow to the brain, which can cause damage to the brain cells and affect various functions, such as movement, sensation, speech, or vision. A stroke patient whose right eye does not close fully may have facial paralysis or weakness on the right side of the face, which can impair the ability to blink or close the eye. This can cause dryness, irritation, or injury to the eye, especially at night. Lubricant eye ointment can help to keep the eye moist and prevent corneal ulcers or infections. The patient may also need to wear an eye patch or tape the eye shut during sleep.

Choice C reason: This is an incorrect choice because a patient with an eye infection after swimming in a pond would not benefit from the use of lubricant eye ointment. An eye infection is an inflammation or infection of the eye or its structures, such as the cornea, the iris, or the eyelid. Swimming in a pond can expose the eye to various microorganisms, such as bacteria, fungi, or parasites, that can cause eye infections. Some examples are Acanthamoeba keratitis, which is a rare but serious infection of the cornea caused by a parasite, or Pseudomonas aeruginosa, which is a common cause of bacterial conjunctivitis. Lubricant eye ointment is not effective against these microorganisms, and it can also interfere with the penetration of antibiotic or antifungal eye drops. The patient with an eye infection after swimming in a pond should seek medical attention and use the prescribed eye drops as directed.

Choice D reason: This is an incorrect choice because a patient who has extended-wear contact lenses in place would not benefit from the use of lubricant eye ointment. Extended-wear contact lenses are soft lenses that can be worn continuously for up to 30 days and nights, without the need to remove them for cleaning or disinfection. However, extended-wear contact lenses can increase the risk of eye infections, such as bacterial or fungal keratitis, which can cause severe pain, redness, blurred vision, or sensitivity to light. Lubricant eye ointment is not compatible with contact lenses, and it can damage the lens material or cause deposits or cloudiness on the lens. The patient who has extended-wear contact lenses in place should follow the instructions of the eye care provider and remove the lenses immediately if any signs of infection or irritation occur.

Choice A reason: This is the correct choice because the patient’s lung sounds are diminished bilaterally with expiratory wheezes is an example of objective data. Objective data is observable and measurable information that can be verified by the nurse or other health care professionals. The nurse can use a stethoscope to listen to the patient’s lung sounds and document the findings.

Choice B reason: This is an incorrect choice because the patient worries that the insurance company will not pay the hospital bill is an example of subjective data. Subjective data is what the patient tells the nurse about their symptoms, feelings, perceptions, and concerns. The nurse cannot observe or measure the patient’s worry, but can only rely on the patient’s verbal report.

Choice C reason: This is an incorrect choice because the patient wonders if supplemental oxygen at home would be beneficial is an example of subjective data. Subjective data is what the patient tells the nurse about their symptoms, feelings, perceptions, and concerns. The nurse cannot observe or measure the patient’s wonder, but can only rely on the patient’s verbal report.

Choice D reason: This is an incorrect choice because the patient felt less short of breath after receiving a nebulizer treatment is an example of subjective data. Subjective data is what the patient tells the nurse about their symptoms, feelings, perceptions, and concerns. The nurse cannot observe or measure the patient’s feeling, but can only rely on the patient’s verbal report.