A nurse caring for a patient who suffered a severe sprain and has an order for a cold pack application to the injured area would prevent patient injury by:.
using heavy pressure on the cold pack for greater effectiveness.
leaving the pack in place for over 30 minutes at a time.
preparing to apply heat instead if cold is not effective.
placing a towel between the pack and the skin.
The Correct Answer is D
Choice A rationale:
Using heavy pressure on the cold pack for greater effectiveness is not the correct approach when applying a cold pack to an injured area. Applying excessive pressure can lead to tissue damage, frostbite, and can be uncomfortable for the patient. Cold packs should be applied with gentle, even pressure to avoid complications.
Choice B rationale:
Leaving the cold pack in place for over 30 minutes at a time is not recommended. Prolonged exposure to cold can also cause tissue damage, including frostbite. It is generally advised to limit cold pack applications to 20-30 minutes at a time to prevent complications.
Choice C rationale:
Preparing to apply heat instead if cold is not effective is not the appropriate action in this scenario. When a healthcare provider orders a cold pack application, it is essential to follow the prescribed treatment plan. Heat should only be considered if it is specifically ordered as an alternative treatment.
Choice D rationale:
Placing a towel between the pack and the skin is the correct approach to prevent patient injury when applying a cold pack. This helps to protect the skin from direct contact with the cold pack, reducing the risk of frostbite or cold-related injuries. It ensures a barrier between the cold pack and the patient's skin, providing a safe and comfortable application.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
The CPAP device should not fit loosely on the face. It should fit snugly to create a proper seal and maintain positive airway pressure. A loose-fitting CPAP mask may not effectively treat obstructive sleep apnea (OSA).
Choice B rationale:
The CPAP device typically delivers consistent pressure throughout both inhalation and exhalation. It does not deliver less pressure during exhalation. The purpose of CPAP is to maintain a constant pressure to keep the airway open during both phases of the respiratory cycle.
Choice C rationale:
The CPAP device does not require an invasive ventilation tube. It uses a mask that covers the nose or both the nose and mouth to deliver positive airway pressure. It is non-invasive and is designed to keep the airway open by delivering pressurized air.
Correct Answer is C
Explanation
Choice A rationale:
An elevated blood pressure is not a reliable indicator of a decrease in pain following the administration of an opioid narcotic. Blood pressure can be influenced by various factors, and it may not directly correlate with the relief of pain.
Choice B rationale:
The client being asleep is not a direct indicator of decreased pain following opioid administration. While opioids may cause drowsiness as a side effect, the absence of pain cannot be confirmed solely based on the patient's sleep state.
Choice C rationale:
An increased respiratory rate can be a reliable indicator of decreased pain following the administration of an opioid narcotic. Opioids often cause respiratory depression, so an increased respiratory rate may suggest that the patient's pain is adequately managed, as they are not experiencing excessive respiratory depression.
Choice D rationale:
Diaphoresis (excessive sweating) is not a direct indicator of decreased pain following opioid administration. Diaphoresis can be caused by various factors, including anxiety, and may not specifically reflect pain relief. .
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