The parol evidence rule

A nurse is assessing a client who has a fracture of the femur. The nurse obtains vital signs on admission and again in 4 hours. Which of the following changes in assessment should indicate to the nurse that the client could be developing a serious complication?

Estoppel is a legal principle that 

An important element that all documents should have is date of record. 

After suctioning a client’s tracheostomy tube, the nurse waits a few minutes before suctioning again. The nurse should use intermittent suction. Why would continuous suction not be applied?

An officer of the company cannot present in a litigation actual records of the incident written by a third party because it is considered hearsay.

You are caring for a mechanically ventilated patient. What is the most accurate way to determine the actual tidal volume your patient is receiving? 

Your patient, Mr. H was intubated and ET tube placement was confirmed. You note that the 23-cm mark on the ET tube is at the level of Mr. H’s teeth and is connected to the ventilator with the following settings:            Tidal Volume= 700 ml            Rate=   14            Fio2= 60 %            PEEP= 10cm            Mode= SIMV            ABGs are obtained 30 minutes later after Mr. H is placed on the ventilator.            pH= 7.31            PaCo2= 65 mmHg            PaO2= 80 mmHg            HC03= 20            O2 saturation – 90%Which ventilator change do you anticipate based on your analysis of the above ABG?

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