Which approach is best for the nurse to use when directing a client with Huntington's disease to the hospital cafeteria?
Provide step by step verbal directions.
Orient the client to the color coding system used for locating hospital services.
Use the hospital map to show the client where the cafeteria is located.
Escort the client to the cafeteria.
The Correct Answer is D
D. For individuals with Huntington's disease, who may experience motor impairments and difficulties with coordination and balance, having someone escort them to the cafeteria could be the most practical and supportive approach.
A. Verbal directions may be a component of assistance but they may not be the most effective approach on their own.
B. Individuals with Huntington's disease may still have difficulties with executive function and orientation, which could limit their ability to effectively use a color coding system independently.
C. Providing a visual representation of the hospital layout using a map could be a helpful approach for a client with Huntington's disease. However, the cognitive and motor impairment present may hinder access even in the presence of a map.
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Related Questions
Correct Answer is A
Explanation
A. Inserting a nasogastric tube (NGT) and attaching it to low intermittent suction would be appropriate in this situation. Dark brown emesis could indicate gastrointestinal bleeding, which may require gastric decompression to prevent further vomiting and assess the volume and characteristics of the gastric contents.
B. Placing an indwelling urinary catheter and attaching a bedside drainage unit is not the priority intervention in this scenario.
C. Sending the client to x-ray for a flat plate of the abdomen may provide diagnostic information, but it is not the most immediate intervention needed in this situation.
D. Giving a prescribed analgesic for a temperature above 101°F (38.3°C) is not the priority intervention in this scenario.
Correct Answer is C
Explanation
C. Type I hypersensitivity reactions, also known as immediate hypersensitivity reactions, involve the production of IgE antibodies in response to an allergen. In this case, the bee sting likely triggered an IgE-mediated immune response, leading to the release of inflammatory mediators such as histamine. The client's symptoms of body rash, shortness of breath, tachycardia, and hypotension are characteristic of anaphylaxis, which is a severe and potentially life-threatening manifestation of Type I hypersensitivity reactions.
A.. Type II hypersensitivity reactions occur when the immune system targets antigens on the body's own cells, leading to cell destruction or dysfunction.
B. Autoimmune responses involve the immune system mistakenly attacking the body's own tissues and organs, leading to inflammation and tissue damage.
D. Cell-mediated hypersensitivity reactions involve the activation of T cells and the release of cytokines, resulting in inflammation and tissue damage. Examples include delayed-type hypersensitivity reactions such as contact dermatitis or tuberculin skin testing reactions.
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