A nurse is preparing to transfer a client from the ICU to the medical floor. The client was recently weaned from mechanical ventilation following a pneumonectomy. Which of the following information should the nurse include in the change-of-shift report?
The frequency in which the client presses the call button
The client's most recent ventilator settings
The time of the client's last dose of pain medication
The last time the provider evaluated the client
The Correct Answer is C
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Out of the provided options, the most important information for the nurse to include in the change-of-shift report is:
c. The time of the client's last dose of pain medication
Here's why:
- a. The frequency in which the client presses the call button: While this could be relevant to assess the client's overall well-being or potential anxiety, it's not as crucial as pain management in this specific scenario.
- b. The client's most recent ventilator settings: Since the client is already weaned from ventilation, this information is no longer pertinent.
- d. The last time the provider evaluated the client: While provider updates are important, especially after major procedures like a pneumonectomy, knowing the exact timing isn't as critical as pain management, especially considering the potential for increased pain after surgery and weaning from ventilation.
- c. The time of the client's last dose of pain medication: Pain management is paramount after a pneumonectomy. Knowing the timing of the last dose allows the receiving nurse to assess the need for further medication and potential for breakthrough pain management. Additionally, it provides a baseline for monitoring pain trends and potential complications related to pain, such as decreased mobility or respiratory compromise.
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Therefore, while all the information listed could be relevant at some point, knowing the time of the last pain medication dose is the most crucial for immediate patient care and should be prioritized in the change-of-shift report for a post-pneumonectomy client transitioning from ICU to the medical floor.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
The provider does not choose a client's healthcare surrogate. Advance directives, including the appointment of a healthcare surrogate, allow individuals to make their own decisions about their medical treatment if they become unable to communicate their wishes. Clients have the right to designate their healthcare surrogate based on their preferences and values. This statement is incorrect as it misrepresents the purpose of advance directives.
Choice B rationale:
A healthcare surrogate does not need to be a family member. The choice of a healthcare surrogate is a personal decision made by the individual. It can be a family member, friend, or any other person whom the individual trusts to make medical decisions on their behalf. There is no requirement that the surrogate must be a family member.
Choice C rationale:
The provider cannot go against the client's wishes regarding advance directives. Advance directives are legally binding documents that outline the individual's preferences for medical treatment, including decisions to withhold or withdraw life-sustaining interventions. Healthcare providers are ethically and legally obligated to respect and follow the directives outlined by the client. Going against the client's wishes would be a violation of their autonomy and legal rights.
Choice D rationale:
The client can resume control of healthcare decisions after a temporary loss of competency if specified in the advance directives. Advance directives often include provisions stating that the individual's decision-making capacity should be
Correct Answer is ["18"]
Explanation
The client weighs 198 lb, which is equivalent to (198 ÷ 2.2 = 90kg.
Therefore, the amount of mannitol for the test dose is 0.2 g/kg x 90 kg = 18 g. The nurse should administer 18 g of mannitol IV bolus over 5 min as a test dose to the client who has severe oliguria.
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