Monday, 22 April 2019

Q. Twenty-four hours after a bone marrow aspiration, the nurse evaluates which of the following as an appropriate client outcome?

A. The client maintains bed rest.
B. There is redness and swelling at the aspiration site.
C. The client requests morphine sulfate for pain.
D. There is no bleeding at the aspiration site.

Correct Answer: D

Explanation: After a bone marrow aspiration, the puncture site should be checked every 10 to 15 minutes for bleeding. For a short period after the procedure, bed rest may be ordered. Signs of infection, such as redness and swelling, are not anticipated at the aspiration site. A mild analgesic may be ordered. If the client continues to need the morphine for longer than 24 hours, the nurse should suspect that internal bleeding or increased pressure at the puncture site may be the cause of the pain and should consult the physician.

Saturday, 20 April 2019

Question Of The Day, Basic Physical Care
Q. A primiparous woman has recently delivered a term infant. Priority teaching for the patient includes information on:

A. Sudden infant death syndrome (SIDS)
B. Breastfeeding
C. Infant bathing
D. Infant sleep-wake cycles

Correct Answer: B

Explanation: Breastfed infants should eat within the first hour of life and approximately every 2 to 3 hours. Successful breastfeeding will likely require sustained support, encouragement, and instruction from the nurse. Information on SIDS, infant bathing, and sleep-wake cycles are also important topics for the new parent, but they can be covered at any time prior to discharge.

Friday, 19 April 2019

Nurse Career, Nursing Exam US, Nursing Responsibilities,

Healthcare market research and consulting company PRC recently announced the results of its National Nursing Engagement Report. The report was based on survey findings from over 2,000 healthcare partners and revealed key data about nurses in the workforce today, as well as what the future will hold for nurses and how hospital administrators can help support nurses going forward.

The Buzz on Nurse Burnout

One of the main focuses of the study was to examine how many nurses in the workplace today report feeling burned out. According to the report, 15.6% of all nurses reported feelings of burnout, with the percentage rising to 41% of “unengaged” nurses. What’s really interesting as well, is that 50% of nurses who reported feeling burned out also reported that they had no plans to leave their organization—pointing to the importance of supporting and meeting nurses where they are at in the workforce.

The report explained that unengaged nurses are nurses who,

◈ May not be part of a team with their colleagues,
◈ Have diminished morale,
◈ Feel emotionally checked out from their work, which also ultimately affects their patient care.

Factors such as autonomy, nurse-to-nurse teamwork and collaboration, staffing and resources, interpersonal relationships, and leadership access and responsiveness were all factors in nursing engagement.

ER nurses also seemed to be at a higher risk for burnout, with 20% of ER nurses reporting feeling unengaged.

“Burnout is an important topic in healthcare today,” the report’s authors, Cynthia King, Ph.D., MA, Director Client Organizational Development, PRC and Leigh Ann Bradley, Ph.D., MSN, MA, BS-CHE, RN, Executive Coach & National Speaker, PRC Excellence Accelerator, explain.

“We are asking nurses to do more with fewer resources. At the same time, nurses must be compassionate caregivers, technical experts, clinicians, and experts.”

Supporting Nurses = Better Patient Care

King and Bradley tell that one of the most exciting findings of the data was the fact that there is a statistical significance between nurse engagement and patients having better experiences. “To us, this highlights the sacred nature of the patient/nurse relationship,” they note. 

You mean when nurses feel more supported at work, they are better able to do their job and care for patients? What a revolutionary idea!

Fortunately, however, 85% of nurses did report feeling engaged or fully engaged, so continuing to support nurses, while also exploring ways to support those who are finding engagement to be lacking, is imperative.

“We believe it is important for healthcare leaders to support and grow an engaged workforce,” they add. “At the same time, leaders need to determine ways to restore joy and purpose to nurses whose engagement has diminished.”

And as the report details, the demand for nurses will increase by 15% by 2026, so it’s more important than ever that nurses feel supported and engaged in the field. King and Bradley also explain that the report revealed that in order to improve engagement, hospital administrators need to primarily focus on three things:

Involve nursing leaders and professionals as active participants in decision making impacting the organization and patient care. It is important that nurses know their opinions are valued by leadership.

Create environments in nursing units where there are respect, teamwork, and collaboration between nurses and other healthcare professionals.

Make leadership accessible to nurses and be responsive to their needs. Having trusting relationships between nursing and the senior leadership of an organization is critical.

The Needs of Millennial Nurses

Despite the reputation that millennials get about working, King and Bradley tell that their research found that all generations—millennials included—are “deeply committed” to the nursing profession. Despite the fact that millennials have a slightly lower percentage of engagement, they also share the same goals and dedication as all other generations studied.

Thus, the report only reveals how important it is for nurse leaders to invest time in building relationships and exploring ways to support millennial nurses. Millennial nurses, as part of a different generation of nurses, may have their own unique needs than past or even future generations, but the paper authors point out that uncovering those expectations and needs will only help improve nurse engagement, retention, and patient care.

Overall, the report provides an important landscape for defining what factors are necessary to help nurses feel engaged in the workplace, what may lead nurses to experience burnout, and how to move forward to ensure that the needs of nurses in all generations are identified and valued.

“Too often nurses are so focused on caring for others, [so] we need to create a safe place to care for nurses,” King and Bradley summarize. “We want to create climates where employees can speak up for help if they are experiencing signs and symptoms of burnout.”
Q. A nurse is caring for a client diagnosed with ovarian cancer. Diagnostic testing reveals that the cancer has spread outside the pelvis. The client has previously undergone a right oophorectomy and received chemotherapy. The client now wants palliative care instead of aggressive therapy. The nurse determines that the care plan's priority nursing diagnosis should be:

A. Acute pain
B. Impaired home maintenance
C. Noncompliance
D. Ineffective breast-feeding

Correct Answer: A

Explanation: Palliative care for the client with advanced cancer includes pain management, emotional support, and comfort measures. The client is in the hospital, so home maintenance doesn't apply at this time. The client has chosen palliative care, so she isn't noncompliant. The client isn't breast-feeding, so the diagnosis of Ineffective breast-feeding doesn't apply.

Thursday, 18 April 2019

Question Of The Day, Respiratory Disorders
Q. A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:

A. "I need to keep my inhaler at the bedside."
B. "I should eat a high-protein diet."
C. "I should become involved in a weight loss program."
D. "I should sleep on my side all night long."

Correct Answer: C

Explanation: Obesity and decreased pharyngeal muscle tone commonly contribute to sleep apnea; the client may need to become involved in a weight loss program. Using an inhaler won't alleviate sleep apnea, and the physician probably wouldn't order an inhaler unless the client had other respiratory complications. A high-protein diet and sleeping on the side aren't treatment factors associated with sleep apnea.

Wednesday, 17 April 2019

Question Of The Day, Neurosensory Disorders
Q. Before cataract surgery, the nurse is to instill several types of eye drops. The surgeon writes orders for 5 gtts of antibiotic in OD, and 3 drops of topical steroid drops in OD. The nurse should:

A. Contact the surgeon to rewrite the order.
B. Administer the antibiotic in the left eye and the steroid in the right eye.
C. Administer both types of drops in the right eye.
D. Contact the pharmacist for clarification of the order.

Correct Answer: A

Explanation: The nurse should not administer drugs without a complete order. In this case the order does not contain information about dosage and uses abbreviations that can cause confusion.

Tuesday, 16 April 2019

Q. A nurse is managing the care of a client with osteoarthritis. Appropriate treatment strategies for osteoarthritis include:

A. administration of opioids for pain control.
B. administration of nonsteroidal anti-inflammatory drugs (NSAIDs) and initiation of an exercise program.
C. administration of monthly intra-articular injections of corticosteroids.
D. vigorous physical therapy for the joints.

Correct Answer: B

Explanation: NSAIDs are routinely used for anti-inflammatory and analgesic effects. NSAIDs reduce inflammation, which causes pain. Opioids aren't used for pain control in osteoarthritis. Intra-articular injection of corticosteroids is used cautiously for an immediate, short-term effect when a joint is acutely inflamed. Normal joint range of motion and exercise (not vigorous physical therapy) are encouraged to maintain mobility and reduce joint stiffness.

Monday, 15 April 2019

Question Of The Day, Endocrine and Metabolic Disorders
Q. When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is:

A. "The physician wants to be sure your shoes fit properly so you won't develop pressure sores."
B. "The circulation in your feet can help us determine how severe your diabetes is."
C. "Diabetes can affect sensation in your feet and you can hurt yourself without realizing it."
D. "It's easier to get foot infections if you have diabetes."

Correct Answer: C

Explanation: The nurse should make the client aware that diabetes affects sensation in the feet and that he might hurt his foot but not feel the wound. Although it's important that the client's shoes fit properly, this isn't the only reason the client's feet need to be checked. Telling the client that diabetes mellitus increases the risk of infection or stating that the circulation in the client's feet indicates the severity of his diabetes doesn't provide the client with complete information.




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