A nurse is providing postmortem care for a client prior to the family viewing the body. Which of the following actions should the nurse take?
Raise the head of the client's bed to 30 degrees.
Cleanse the client's body while wearing sterile gloves
Remove the client's dentures and close their mouth
Apply surgical tape to the client's eyes
The Correct Answer is A
After a patient dies, postmortem care includes preparing them for family viewing. The nurse should place the body in the supine position, with the arms at the sides and the head on a pillow. Then elevate the head of the bed 30 degrees to prevent discoloration from blood settling in the face .
The other options are not correct because:
b) The nurse should cleanse the client's body while wearing appropriate personal protective equipment (PPE) based on indications for isolation precautions, not necessarily sterile gloves.
c) If the patient wore dentures and your facility’s policy permits, gently insert them; then close the mouth
d) The nurse should close the eyes by gently pressing on the lids with their fingertips. If they don’t stay closed, place moist coton balls on the eyelids for a few minutes, and then try again to close them. Surgical tape is not mentioned as necessary .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Montelukast is a medication commonly prescribed for the management of asthma symptoms, including the prevention of asthma attacks. The recommended dosing regimen for montelukast is typically once daily, usually in the evening. This helps to provide continuous control of asthma symptoms and reduce the risk of asthma exacerbations.
Administer the medication when the toddler has an acute asthma attack: Montelukast is not intended for immediate relief during an acute asthma attack. It is a long-term control medication aimed at preventing asthma symptoms and reducing the frequency and severity of attacks. For acute asthma attacks, a short-acting bronchodilator such as albuterol is typically used.
Provide an additional dose of the medication prior to physical activity: Montelukast is not specifically indicated as a pre-exercise medication for asthma. However, in some cases, healthcare providers may prescribe it if exercise-induced bronchoconstriction is a significant concern. It is important to follow the specific instructions provided by the healthcare provider regarding medication use before physical activity.
Mix the medication in juice prior to administration: Montelukast tablets or chewable tablets should not be crushed or mixed in juice unless specifically instructed by the healthcare provider. They should be administered whole and taken with water. If the child has difficulty swallowing tablets, alternative formulations like oral granules or chewable tablets may be available.
Correct Answer is D
Explanation
Answer: (D) Refrigerate the specimen until the time of transport to the laboratory
Rationale:
A) Collect 2 ml of sputum in an emesis basin: While it is important to collect an adequate volume of sputum, using an emesis basin is inappropriate for collecting a specimen for culture and sensitivity. Sputum must be collected in a sterile container to avoid contamination, ensuring the accuracy of the culture results.
B) Instruct the client to rinse with an antiseptic mouthwash prior to specimen collection: Using an antiseptic mouthwash before collecting a sputum specimen is not recommended, as it could contaminate the sample with antiseptic agents, potentially affecting the growth of microorganisms in the culture. The client should rinse with plain water instead.
C) Swab the oropharynx with a sterile swab: Swabbing the oropharynx is more appropriate for collecting a throat culture rather than a sputum specimen. Sputum collection requires the client to expectorate mucus from the lower respiratory tract, not from the oropharynx, to obtain an accurate sample for culture and sensitivity.
D) Refrigerate the specimen until the time of transport to the laboratory: Refrigerating the sputum specimen is crucial to preserve the integrity of the sample and inhibit the growth of contaminants before it is transported to the laboratory. This action helps ensure that the results of the culture and sensitivity test are accurate.
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