A nursing diagnosis of "Risk for Deficient Fluid Volume" related to excessive fluid loss, secondary to diarrhea and vomiting was implemented for a home health client who began with these symptoms 5 days ago. A goal was set that the client's symptoms would be eliminated within 48 hours. The client is being seen after a week and has had no diarrhea or vomiting for the past 5 days. What should the nurse do?
Document that the potential problem is being prevented from recurring.
Document that the problem has been resolved and the goal has been met.
Assume that whatever the cause was, the symptoms may return, but the goal was met.
Keep the problem on the care plan in case the symptoms return.
The Correct Answer is B
The nursing diagnosis was "Risk for Deficient Fluid Volume" related to excessive fluid loss, secondary to diarrhea and vomiting. The goal was set that the client's symptoms would be eliminated within 48 hours. The client is being seen after a week and has had no diarrhea or vomiting for the past 5 days, indicating that the problem has been resolved. Therefore, the nurse should document that the problem has been resolved and the goal has been met.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
When planning interventions to promote a client's appetite, it would be important to include providing a tidy, clean environment that is free of unpleasant sights or odors and encouraging or providing oral hygiene after mealtime in the client's plan. A pleasant and comfortable environment can help stimulate the appetite and make mealtime more enjoyable. Good oral hygiene can also help improve the taste of food and promote appetite. Unpleasant or uncomfortable treatments should not be performed before or after a meal as they may decrease the client's appetite. Providing unfamiliar food may not be helpful in promoting appetite as clients may prefer familiar and comforting foods.
Correct Answer is D
Explanation
Developmental testing for kindergarten through third-grade students is an example of primary prevention. Primary prevention aims to prevent disease or injury before it occurs by promoting healthy behaviors and reducing exposure to risk factors.
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