NUR2356 MDC 1 Exam 1 (Answered) With Verified Solution

NUR2356 MDC 1 Exam 1 (Answered) With Verified Solution Complications of urinary elimination - UTIs UTI patient education - wipe front to back - pee before and after sex - cleanse beneath foreskin - provide catheter care regularly (nurses) A client who has an indwelling catheter reports a need to urinate. Which of the following actions should the nurse take? A. Check to see whether the catheter is patent B. Reassure the client that it is not possible for them to urinate. C. Recatheterize the bladder with a larger-gauge catheter. D. Collect a urine specimen for analysis. A nurse is preparing to initiate a bladder-retraining program for a client who has incontinence. Which of the following actions should the nurse take? (Select all that apply.) A. Restrict the client's intake of fluids during the daytime. B. Have the client record urination times. C. Gradually increase the urination intervals. D. Remind the client to hold urine until the next scheduled urination time. E. Provide a sterile container for urine A nurse is reviewing factors that increase the risk of urinary tract infections (UTIs) with a client who has recurrent UTIs. Which of the following factors should the nurse include? (Select all that apply.) A. Frequent sexual intercourse B. Lowering of testosterone levels C. Wiping from front to back to clean the perineum D. Location of the urethra closer to the anus E. Frequent catheterization A nurse is teaching a client who reports stress urinary incontinence. Which of the following instructions should the nurse include? (Select all that apply.) A. Limit total daily fluid intake. B. Decrease or avoid caffeine. C. Take calcium supplements. D. Avoid drinking alcohol. E. Use the Credé maneuver When you see indications of skin breakdown, what is your next action? - Elevate and use corrective devices (pillows, foot boots, trochanter rolls, splints, wedge pillows) What does PQRST stand for? Palliative/Provoking Quality Region/Radiation Severity Timing What are some nonverbal signs of pain? - grimacing - moaning - flinching - guarding - decreased attention span - restlessness, pacing What do vital signs look like during acute pain? - BP increased - Pulse increased - RR increased Before nurses give a pain medication, what should they assess? - drug interactions - allergies - vital signs - side effects What are common side effects to pain medications? - low BP - low HR - sedation - respiratory depression - orthostatic hypotension - urinary retention - nausea/vomiting - constipation After administering pain medication, what is the follow up? - reevaluate pain level - if given orally, follow up q 1 hour - if given IV, follow up q 15 min - check vital signs! What are the complications related to pain management? - anxiety - fear -depression - slower healing - slower recovery superficial pain usually involving the skin or subcutaneous tissue - cutaneous pain pain in internal organs (the stomach or intestines). It can cause referred pain in other body locations separate from the stimulus - visceral pain a type of neuropathic pain: sensation of pain without demonstrable physiologic or pathologic substance; commonly observed after the amputation of a limb - phantom pain Arises from abnormal or damaged pain nerves. It includes phantom limb pain, pain below the level of a spinal cord injury, and diabetic neuropathy: "pins and needles" - neuropathic pain Difference between acute and chronic pain? - -acute pain: lasts less than 6 mnths, caused by something specific e.g. broken bone - -chronic pain: lasts more than 6 mnths, caused by an underlying issue, affects ADLs Chronic pain without identifiable physical or psychological cause - idiopathic pain Non-Pharmacological Pain Management strategies - cognitive behavioral measures: changing the way a client perceives pain, and physical approaches to improve comfort - cutaneous stimulation: cold, heat, therapeutic touch, massage, TENS - distraction: ambulation, deep breathing, visitors, television, games, prayer, music - relaxation: yoga, meditation, progressive muscle relaxation - imagery: pleasant thought, ability to concentrate - acupuncture/acupressure - elevation of edematous extremities Stages of Therapeutic Communication Pre-interaction Orientation Working Termination Pre-interaction phase - phase is established even before you meet the client - begin establishing communication by gathering information about the client, but the nurse and client do not have direct communication. Orientation phase - begins when you meet the client and introduce yourself and your role in the relationship. - goal is to establish rapport and trust through the use of verbal and nonverbal communication. Working phase - The bulk of therapeutic communication occurs in this phase - the nurse communicates caring, the patient expresses thoughts and feelings, mutual respect is maintained, and honest verbal and nonverbal expression occurs. Termination phase - The conclusion of the relationship, whether at the end of the nurse's shift or on the client's discharge from the unit, facility, or service. - Reviewing and summarizing help to bring the relationship to a comfortable conclusion. The 5 key characteristics of therapeutic communication -empathy -respect -genuineness -concreteness -confrontation Name ways to enhance therapeutic communication -Active listening -Establishing trust -Being assertive -Restating, clarifying, and validating messages -Interpreting body language and sharing -observations -Exploring issues -Using silence -Summarizing the conversation -Process recordings Name some barriers to therapeutic communication -Asking too many questions -Asking why -Fire-hosing information -Changing the subject inappropriately -Failing to probe -Expressing approval or disapproval -Offering advice -Providing false reassurance -Stereotyping -Using patronizing language Name some non-verbal communication -Facial expression -Posture and gait -Personal appearance -Gestures -Touch Complementary therapy -therapeutic or preventive health care practices, such as homeopathy, naturopathy, chiropractic, and herbal medicine - do not follow generally accepted medical methods and may not have a scientific explanation for their effectiveness - used (alongside) in addition to or to enhance conventional medical care Alternative therapy -includes herbs and other "natural" products. -not controlled or tested by the U.S. Food and Drug Administration. -are considered to be dietary supplements -used instead of modern medicine - often the basis for discovery of an active ingredient that is later developed into a regulated medication treatment approaches that are used to enhance conventional medical care