An older-adult woman, Mrs. Patel, is a new resident at the l…
An older-adult woman, Mrs. Patel, is a new resident at the long term care center. You discover while taking the nursing history that she is experiencing urinary incontinence (UI). When asked about toileting habits, she tells you she will feel that her bladder is full, but doesn’t “feel like I can get all of the urine out, and I often find my underwear are wet.” This has been going on for about 3 years now. When you ask her about what she does to get out or socialize, she is hesitant to go far because she is afraid of wetting without knowing it and carrying an odor that would be embarrassing to her. What type of urinary incontinence is Mrs. Patel experiencing?
Read DetailsWhich entry will require follow-up by the nurse manager? 080…
Which entry will require follow-up by the nurse manager? 0800: Patient states, “fell out of bed.” Patient found lying by bed on the floor. No abnormalities noted with extremities, peripheral pulses strong, bilateral strengths equal, no bruising or bleeding. Neuro check within normal limits. Patient states, “did not pass out”. Assisted back to bed. Bed in low position and locked, side rails up x 2 and call light in reach. Bed monitor on———————————————–Jane More, RN 0810 Notified primary care provider of patient’s status. New orders received.——————————————————-Jane More, RN 0815 Portable x-ray of left hip taken in room. Patient states, “I feel fine.” ———————————————————-Jane More, RN 0830: Incident/occurence report completed and placed in the patient’s chart—Jane More, RN
Read DetailsThe nurse reviews part of a nurses’ notes entry for a 48-yea…
The nurse reviews part of a nurses’ notes entry for a 48-year-old client admitted to the inpatient psychiatric unit after a suicide attempt. 1100: Admitted to unit for observation and treatment related to a suicide attempt. Attempted to cut both wrists, which are currently bandaged. Client was in a severe motor vehicle accident 5 months ago, resulting in quadriplegia. has been living in a group home with full-time caregiver for assistance with ADLs since discharge from rehabilitation. Has no family living in the area. Has stage 3 sacral pressure injury covered with gauze dressing. Recently completed a course of antibiotics for infected sacral wound. Wears an external condom catheter and follows bowel regimen but has frequent problems with urine leakage and bowel incontinence. Is able to transfer with supervision from bed to wheelchair using sliding board. Lost 20 lb (9.1 kg) since the accident and describes appetite as “fair.” Does not want to be here because he is “sick of being in hospitals.” Which client findings are of immediate concern to the nurse related to risk factors for additional or worsening pressure injuries? Select all that apply.
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