What does a nurse do when a patient refuses to be discharged?
A nurse is caring for a client who refuses treatment and asks to be discharged from the hospital against medical advice. The nurse notifies the client's provider, who tells the nurse to restrain the client, if necessary, to keep her from leaving the hospital.
How do you address the issue of patient refusal of a nurse?
Develop a plan to address the refusal and support staff. Addressing the issue of patient refusal of a nurse assignment requires understanding three factors: the patient, the nurse, and the organization.
What does a nurse caring for a client who has depression observe?
A nurse caring for a client who has depression observes the client comes to breakfast freshly bathed, wearing clean clothes , and with combed and styled hair. Which of the following responses by the nurse is therapeutic?
What happens when a nurse administers an incorrect medication to a client?
A nurse administers an incorrect medication to a client. Following an assessment of the client, the nurse determines that the client has experienced no untoward effects as a result of the medication.
What is a nurse's discharge teaching?
The nurse's discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity ?
What is a nurse in an acute mental health unit?
A nurse in an acute mental health unit is admitting a client who has bipolar disorder. Which of the following findings supports the admitting dx of acute mania? The client responds to questions with disorganized speech. A nurse is planning care for a group of clients on a mental health unit.
What is the role of a nurse in bipolar disorder?
The client is running around the unit trying to organize competitive games with the clients.
What is a nurse planning care for?
A nurse is planning care for a client who is in the manic phase of bipolar disorder.
What is a nurse in AMA?
A nurse is caring for a client who refuses treatment and asks to be discharged from the hospital AMA. The nurse notifies the client's provider, who tells the nurse to restrain the client, if necessary, to keep her from leaving the hospital.
What is a nurse's role in AMA?
A nurse is caring for a client who refuses treatment and asks to be discharged from the hospital AMA. The nurse notifies the client's provider, who tells the nurse to restrain the client, if necessary, to keep her from leaving the hospital. The nurse understands that restraining this client would be considered which type of civil action by the nurse?
What does it mean when a nurse vomits?
Vomiting is an indication of toxicity. A nurse is caring for a client who is discussing his PTSD and states: Everyone thinks you should be able to put it out of your mind. It happened so long ago - just get over it! The nurse responds: IT must be very frustrating to encounter this kind of attitude.
What is a nurse's role in a client who refuses treatment?
A nurse is caring for a client who refuses treatment and asks to be discharged from the hospital against medical advice. The nurse notifies the client's provider, who tells the nurse to restrain the client, if necessary, to keep her from leaving the hospital. The nurse understands that restraining this client would be considered which type of civil action by the nurse?
What happens when a nurse administers an incorrect medication to a client?
Following an assessment of the client, the nurse determines that the client has experienced no untoward effects as a result of the medication. The nurse does not complete an incident report because no harm came to the client. Which of the following ethical principles did the nurse violate?
What is a nurse in surgery?
A nurse is providing care to a client who is on strict bed rest following surgery. The nurse assists the patient to the bedside commode and the client sustains an injury to the operative area. Which of the following types of torts has the nurse committed?
What is a nurse teaching a class on torts?
The nurse should instruct the class that administering an antibiotic medication to a competent client after the client has refuse d it is an example of which of the following torts?
What is a nurse assisting?
A nurse is assisting a newly licensed nurse with delegating tasks to an assistive personnel on the unit. Which of the following statements by the nurse explains the purpose of delegation?
What is the nursing student's final term?
A nursing student in the final term of nursing school is overheard by a nursing faculty member telling another student that she got to insert a nasogastric tube in the emergency department while she was working as a nursing assistant. What advice is best for the nursing faculty member to give to the nursing student?
Why doesn't the nurse want the same nurse to care for his patients?
The nurse hears a physician say to the charge nurse that he doesn't want that same nurse caring for his patients because she is stupid and won't follow his orders. The physician also writes on his patient's medical records that the same nurse, by name, is not to care for any of his patients because of her incompetence.
When using the airway, breathing, circulation approach to client care, the nurse should determine that the priority goal is to?
When using the airway, breathing, circulation approach to client care, the nurse should determine that the priority goal is to prevent the client from aspirating. Because the client's jaws are wired together, aspiration of emesis is a possibility. Therefore, the client should be given medication for nausea, and wire cutters should be kept at the bedside in case of vomiting.
Why should a nurse keep wire cutters at bedside?
Because the client's jaws are wired together, aspiration of emesis is a possibility. Therefore, the client should be given medication for nausea, and wire cutters should be kept at the bedside in case of vomiting. A nurse is caring for an antepartum client who has iron-deficiency anemia.
How long should a nurse feed a client with hyperthyroidism?
Feedings should last 20 to 30 minutes. A nurse is assessing a client who is admitted with hyperthyroidism. The client reports a weight loss of 5.4 kg in the last 2 months, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness.
Why do you pull curtains around a client's bed?
Pulling the curtains around the client's bed assures privacy for the client should someone open the door or enter the room.
Is hypotension correct?
Hypotension is correct. Lack of sympathetic input can cause a decrease in blood pressure . The nurse should maintain the client's SBP at 90 mm Hg or above to adequately perfuse the spinal cord. Absence of bowel sounds is correct.
Is a weak gag reflex correct?
Weakened gag reflex is correct. The nurse should monitor the client for difficulty swallowing, or coughing and drooling noted with oral intake.
What was the charge nurse's attitude when talking to the oncoming nurse?
During the phone call while talking with the oncoming nurse, the charge nurse was pleasant and accepting that the nurse would be late. However, once the phone call ended, the charge nurse then complained about the nurse always being late to the other staff. The charge nurse exhibited a passive-aggressive style of communication.
What is a nurse in a provider's office?
A nurse in a provider's office is caring for a client who has hypertension during a follow-up appointment and is focusing on the client's ability to make healthy behavior changes. Which of the following statements by the nurse is an example of the use of affirmations?
What is the role of a nurse in a PACU?
A nurse in the PACU is determining if a client has pain. The client is drowsy and opens their eyes to verbal stimuli but is unable to communicate their pain level. Which of the following actions should the nurse take?
Why should a nurse request an interpreter?
The nurse should request a facility-approved interpreter to assist with the communication barrier. This would also ensure that the information is correct and gives both the nurse and client an opportunity to ask questions.
What is hospice nurse?
A hospice nurse is caring for a client who states that they want to have their last rites before they die. The nurse recognizes that which of the following factors is influencing the client's request?
Why should a well lit room be used in a nursing presentation?
The nurse should identify that a well-lit room can allow the participants to better see the presentation as well as the nurse during the teaching.
How to determine pain level of a client?
The nurse should use an alternative method for determining the client's pain level by observing facial expressions (grimacing or clenching of the teeth); body movements, including restlessness, muscle tension, or resisting movement; and vocalizing discomfort by moaning, grunting, or crying.
What is the nursing action of a client inpatient mental health unit?
A nurse on an inpatient mental health unit is admitting a client who has panic-level anxiety. After showing the client to his room, which of the following nursing actions is most therapeutic at this time? Remain with the client for a while. A nurse is caring for a client who has bipolar disorder.
What does a nurse admit to a patient with major depressive disorder?
A nurse admits a patient with major depressive disorders hearing voices to harm herself and others. The recognize the patient is displaying. Positive symptoms. A nurse is caring for a client who has a depressive disorder. The client states, "I just can't feel any happiness or joy in life.".
What is a nurse's job?
A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The client's spouse asks the nurse about the possible side effects of the ECT. Which of the following responses should the nurse make?
What is a nurse in a mental health facility?
A nurse in a mental health facility is caring for a client who is upset about the loss of privileges due to repetitive negative behavior. Which of the following statements by the nurse demonstrates the effective use of assertive communication?
What is a nurse in a psychiatric unit?
A nurse in a psychiatric unit is admitting a client who attacked a neighbor. The nurse should know that the client can be kept in the hospital after the 72-hr hold is over for which of the following conditions?
What is a nurse teaching about confidentiality?
A nurse is caring for a group of clients on a mental health unit.
What is a nurse on an acute mental health unit?
A nurse on an acute mental health unit is caring for a group of clients. For which of the following clients is seclusion contraindicated?
What is the response of a nurse to an alcohol withdrawal client?
This response by the nurse presents reality and shows empathy by acknowledging the client's feelings.
What should a nurse do during the acute phase of assault?
During the acute phase following assault, the nurse should encourage the client to provide information which may be helpful with treatment and to reduce the client's anxiety.
How does a nurse promote problem solving?
The nurse should promote problem-solving by helping the client identify situations which can or cannot be controlled. This can help the client deal with unresolved issues. A school nurse is talking with a 13-year old female at her annual health screening visit.
What is discharge teaching?
A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity. The client runs 4 miles outdoors every afternoon.
What is an involuntary admission?
The criteria for involuntary admission includes that the client has a mental disorder that will likely result in serious bodily harm to self or another person, unless the client remains in a psychiatric facility. A nurse is caring for a client who is dying.
Why is the open ended response therapeutic?
This response is open-ended, and this response is therapeutic because it offers the client recognition of positive behavior and encourages further discussion.
Why do nurses do nutritional assessments?
According to the nursing process, the nurse should perform an assessment first to gather enough data regarding nutritional status and other findings in order to plan, implement, and evaluate care. The assessment identifies client nutrition needs as well as complications the client might be experiencing related to the eating disorder.
What should a nurse manager do during a refusal incident?
During the refusal incident, the nurse manager should allow the primary nurse to take the lead in determining what type of support they need. Some nurses may want to handle the situation themselves, while others may require assistance from the manager.
How does patient rejection affect nurses?
Patient rejection can be traumatizing and demeaning for the nurse involved and the staff who witness it. Empathy, active listening, and expressions of solidarity with the staff will enhance individual and team resiliency. How these situations are handled brings light to the culture of the unit and the organization as a whole.
Why is it important for hospitals to provide a safe work environment?
Hospitals have a duty to provide a safe work environment for nurses and at the same time provide appropriate care to patients. Creating a healthy work environment enables nurses to provide the highest standards of compassionate patient care while being fulfilled at work. Civility and mutual respect between patients and staff are minimum expectations.
What should nurses do when derogatory language is being used?
If derogatory language is being used, the nurse should remind the patient about behavioral expectations while in the hospital. The staff should communicate boundaries early and explain the organization’s zero-tolerance policy regarding abusive language toward staff.
How to redirect conversation in a hospital?
The nurse can redirect the conversation by letting the patient know that the staff is a diverse group of individuals who are qualified to fulfill a professional role. Politely reminding the patient that the hospital’s goal is the patient’s goal—safe, high-quality care—can help steer the conversation toward the patient with a focus on providing care.
When should a nurse manager be notified?
The nurse manager should be notified as soon as a patient refuses care so they can support the nurse and speak with the patient. If the request is due to misinformation, the nurse leader or nursing staff can educate the patient. For example, if a patient believes that nurses with accents are trained in inferior schools outside the United States, the nurse can explain that all nurses in the United States must pass the same licensure exam regardless of education origin.
What is the first step in addressing a refusal?
A vital first step in addressing a refusal is to assess the patient’s safety. If the patient’s life is in danger, all efforts must be made to stabilize them, even if a short-term accommodation is needed. After the patient is stabilized, the assigned nurse should feel empowered to ask the patient why they made the request, but this is easier said than done and will require support from the nurse manager, nursing leadership, and the organization.