A nurse in an emergency department is preparing a client for emergency surgery. The client's blood alcohol level is 180 mg/dL. Which of the following actions is the nurse's priority?
Apply anti-embolic stockings.
Insert an NG tube.
Obtain consent for surgery.
Insert an indwelling urinary catheter.
The Correct Answer is C
Choice A rationale: Applying anti-embolic stockings may be important for preventing complications but is not the immediate priority.
Choice B rationale: Inserting an NG tube may be part of the preoperative preparation but is not the priority.
Choice C rationale: Obtaining consent for emergency surgery is the priority, ensuring that the client or legally authorized representative provides informed consent before the procedure.
Choice D rationale: Inserting an indwelling urinary catheter may be part of the preoperative preparation but is not the priority.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale: Regular insulin is used to manage diabetes mellitus, not diabetes insipidus.
Choice B rationale: Furosemide is a diuretic and would further increase urine production, which is not appropriate for diabetes insipidus.
Choice C rationale: Lithium is not used to treat diabetes insipidus; it is more commonly used for bipolar disorder.
Choice D rationale: Desmopressin is a synthetic form of antidiuretic hormone (ADH) and is used to treat diabetes insipidus by reducing excessive urine production.
Correct Answer is B
Explanation
Choice A rationale: Recommending staying at a local shelter may be considered, but exploring available community resources first is appropriate.
Choice B rationale: Contacting the local Department of Health and Human Services is the appropriate action to explore available resources and assistance for the client who cannot afford heating during the winter.
Choice C rationale: Contacting the client's family members without the client's consent may violate privacy and confidentiality.
Choice D rationale: Providing information about the dangers of hypothermia is important, but the immediate concern is addressing the client's current situation and exploring available resources.
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