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Exhibits

The practical nurse (PN) is preparing to change the turban dressing.

For each intervention, click to indicate whether it is indicated or not indicated for the dressing change. Each row must have one

A.

Clean the site using sterile gauze and sterile water.

B.

Place client in a private room.

C.

Avoid hand sanitizer after the procedure.

D.

Place the soiled dressing in a red biohazard bag.

E.

Use sterile gloves to remove

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"}}

  1. Clean the site using sterile gauze and sterile water.
    • Indicated: The turban dressing should be changed using sterile techniques to prevent infection and ensure proper wound care.
  2. Place client in a private room.
    • Not Indicated: The client is already on contact precautions for MRSA, so the private room is a general requirement and not a specific intervention for the dressing change.
  3. Avoid hand sanitizer after the procedure.
    • Not Indicated: Hand sanitizer is typically used before and after procedures. For MRSA contact precautions, hand hygiene is critical, and proper hand washing or using hand sanitizer is recommended after the procedure.
  4. Place the soiled dressing in a red biohazard bag.
    • Indicated: The soiled dressing is considered contaminated and should be disposed of in a red biohazard bag to prevent the spread of infection.
  5. Use sterile gloves to remove the old dressing.
    • Indicated: Sterile gloves are required for removing and replacing the dressing to maintain a sterile field and prevent infection.


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Related Questions

Correct Answer is B

Explanation

A. Exhaling slowly after two seconds is not part of the incentive spirometer use. Proper technique involves a slow, steady inhalation, not exhalation.
B. Blowing forcefully into the mouthpiece indicates incorrect use of the spirometer. The client should inhale slowly and deeply through the mouthpiece to expand the lungs and improve ventilation.
C. Using a tight seal around the mouthpiece is correct and necessary to ensure that the spirometer measures the volume of air accurately.
D. Sitting upright during the treatment is correct as it maximizes lung expansion and facilitates deep breathing.

Correct Answer is A, F, E

Explanation

A. Take the child's pulse

Assessing the pulse is crucial to determine if the child has a heartbeat and to evaluate the effectiveness of CPR. This helps to determine the current cardiovascular status of the child and the urgency of further resuscitation efforts.

F. Determine if the child's airway is clear

Ensuring a clear airway is a priority in any emergency situation. A blocked airway can prevent effective ventilation and oxygenation, which is critical for a child who has experienced a near-drowning incident.

D. Start a peripheral IV line

Starting a peripheral IV line is important for administering fluids and medications that may be necessary for resuscitation and stabilization. It allows for rapid access to the child's circulatory system for necessary interventions.

E. Look for any open wounds

Checking for open wounds is necessary to identify any immediate sources of bleeding or potential infections that need to be addressed. It is part of a thorough initial assessment to ensure comprehensive care for the child.

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