You have a patient who has a brain tumor and is at risk for seizures. In the patient's plan of care you incorporate seizure precautions. Select the 3 choices below for all the proper steps to take in initiating seizure precautions. (Select All that Apply.)
Bed in highest position
Remove restrictive objects or clothing from patients’ body
Remove all pillows from the patient's head
Oxygen and suction at bedside
Padded bed rails
Correct Answer : B,D,E
A. Bed in highest position:
The height of the bed is not directly related to seizure precautions.
B. Remove restrictive objects or clothing from patients’ body:
This is important to prevent injury during a seizure episode.
C. Remove all pillows from the patient's head:
While it's generally a good practice to remove pillows to prevent suffocation or obstruction, it's not specifically related to seizure precautions.
D. Oxygen and suction at bedside:
Oxygen and suction should be readily available to support the patient's respiratory status and clear any secretions or vomit during or after a seizure.
E. Padded bed rails:
Padded bed rails can help prevent injury if the patient thrashes or moves violently during a seizure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Reports of exposure to a skin irritant:
This finding is consistent with contact dermatitis, as it typically occurs due to exposure to irritants or allergens. Therefore, it is an expected finding.
B. Elevated temperature:
Elevated temperature is not typically associated with contact dermatitis unless there is a secondary infection. It is not a typical finding in uncomplicated contact dermatitis.
C. Denial of pruritus:
Pruritus, or itching, is a common symptom of contact dermatitis. Clients with contact dermatitis often experience itching or discomfort in the affected area. Therefore, denial of pruritus would be an unexpected finding.
D. Reports of joint discomfort:
Joint discomfort is not typically associated with contact dermatitis. Contact dermatitis primarily affects the skin and does not usually involve the joints. Therefore, reports of joint discomfort would be an unexpected finding.
Correct Answer is A
Explanation
A. No treatment is necessary, the fluid is reabsorbing normally:
- This option suggests that the hydrocele is resolving spontaneously, which is often the case in infants. The physician may choose to observe the hydrocele over time as it is likely to resolve without intervention.
B. Keeping the infant in a flat, supine position until the fluid is gone:
- This option does not address the underlying cause of the hydrocele and is not a standard treatment recommendation. Additionally, positioning changes are unlikely to affect the resolution of the hydrocele.
C. Referral to a surgeon for repair:
- Surgical repair may be considered if the hydrocele persists beyond a certain age or if it causes discomfort or complications. However, it is typically not recommended in infants unless the hydrocele persists beyond infancy or causes other issues.
D. Massaging the groin area twice a day until the fluid is gone:
- Massaging the groin area is not a recommended treatment for hydrocele and may not be effective in resolving the condition. Additionally, manipulating the scrotum may cause discomfort or injury to the infant.
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