The practical nurse (PN) is assessing an older adult client with left-sided heart failure (HF). Which intervention is most important for the PN to implement?
Measure urinary output.
Auscultate all lung fields.
Check mental acuity.
Inspect for sacral edema.
The Correct Answer is B
A. Measure urinary output.
Measuring urinary output is important for monitoring fluid balance but is not the most critical intervention for assessing left-sided heart failure specifically.
B. Auscultate all lung fields.
Auscultating lung fields is crucial for assessing signs of pulmonary edema, a key symptom of left-sided heart failure. It provides direct information about the severity of the condition and guides further management.
C. Check mental acuity.
Checking mental acuity can be useful but is not the most critical intervention for managing left-sided heart failure. It is less directly related to evaluating the severity of heart failure compared to lung auscultation.
D. Inspect for sacral edema.
Inspecting for sacral edema is more relevant for right-sided heart failure. For left-sided heart failure, the priority is evaluating pulmonary symptoms, not peripheral edema.
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Related Questions
Correct Answer is C
Explanation
A. Describing the procedure in detail can increase anxiety or focus the client on the pain rather than distracting them from it.
B. Asking the client to describe the pain could heighten their awareness of it, which is counterproductive to the goal of distraction.
C. Encouraging the client to reminisce about a favorite past family event is a distraction technique that shifts the client's focus away from the pain, helping to manage discomfort during the procedure.
D. Explaining alternative pain management strategies is useful but not a distraction technique; it does not provide immediate relief or shift the client's focus during the procedure.
Correct Answer is ["B","D","E"]
Explanation
A. Bacterial conjunctivitis is not a reportable infectious disease according to the CDC. While it is a common condition, it does not fall under the mandatory reporting requirements for public health.
B. Diphtheria is a reportable disease because it is a severe bacterial infection that can lead to outbreaks and severe health consequences. Reporting helps track and control the spread of this potentially life-threatening disease.
C. Pediculosis (head lice) is not a reportable disease by the CDC. It is a common parasitic infestation but does not require mandatory reporting for public health surveillance.
D. Anthrax is a reportable disease due to its potential for severe illness and its use as a bioterrorism agent. Reporting anthrax is crucial for monitoring and managing outbreaks and potential public health threats.
E. Tuberculosis is a reportable disease because it is a serious infectious disease that can spread in communities and requires public health measures to manage and prevent outbreaks.
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