A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change-of-shift report?
The time the client received his last dose of pain medication
The belief that the client has a difficult relationship with his son
The steps to follow when providing wound care
The client's preferred time for bathing
The Correct Answer is A
- A) Knowing the time the client received his last dose of pain medication is crucial for continuity of care, ensuring that the client receives their next dose on time and pain management is consistent.
- B) Personal beliefs about the client's relationships are not relevant to the medical care and should remain confidential unless it directly impacts the care plan.
- C) While important, the detailed steps for wound care will be included in the client's care plan and are not typically communicated during a change-of-shift report unless there is a change or an issue.
- D) The client's preferred time for bathing is a part of personal care preferences and, while important for client comfort, is not critical information for a change-of-shift report unless it affects immediate care needs.
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Related Questions
Correct Answer is A
Explanation
Rationale:
a. Droplet precautions require healthcare workers to wear a surgical mask when within 3 feet of the client to prevent the transmission of respiratory droplets containing infectious agents like influenza.
b. While high-efficiency particulate air (HEPA) filtration systems can help improve air quality, they are not specifically required for implementing droplet precautions.
c. N95 respirators are typically reserved for airborne precautions, which are not indicated for influenza.
d. Assigning the client to a room with positive airflow is not necessary for implementing droplet precautions; standard precautions such as wearing a surgical mask are sufficient.
Correct Answer is A
Explanation
a. In emergency situations where obtaining informed consent is not feasible due to the client's unconscious state and immediate need for surgery to preserve life or prevent further harm, the client may be transported to the operating room without obtaining formal consent. This action is based on the principle of implied consent for emergent, life-saving interventions.
b. Delaying surgery to obtain informed consent could result in further harm to the client if immediate intervention is necessary to stabilize their condition.
c. Obtaining telephone consent from the facility administrator is not appropriate in this situation, as the client's immediate medical needs take precedence over administrative procedures.
d. Asking the anesthesiologist to sign the consent is not appropriate, as consent should ideally be obtained from the client or their legally authorized representative.
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