A 17-year-old patient, dying of heart failure, wants to have organs removed for transplantation after death. Which action by the nurse is correct?
Notify the health care provider about the patient's desire to donate organs.
Contact the United Network for Organ Sharing after talking with the patient.
Instruct the patient to talk with parents about the desire to donate organs.
Prepare the organ donation form for the patient to sign while still oriented.
The Correct Answer is C
A. Notifying the health care provider is not the most appropriate first action, as parental consent is needed.
B. Contacting the United Network for Organ Sharing is premature without consent from the parents.
C. Since the patient is a minor, parental consent is generally required for organ donation. Instructing the patient to discuss this desire with their parents is essential for obtaining legal consent.
D. Preparing the organ donation form is also premature, as minors cannot legally consent without parental approval.
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Correct Answer is D
Explanation
A. Assessment has already been completed as the initial step, involving data collection.
B. Diagnosis is also completed, involving analysis and identification of the patient’s health problems.
C. Implementation occurs after planning, when nursing interventions are executed.
D. Planning is the appropriate next step, involving the creation of specific, measurable goals and interventions based on the identified nursing diagnoses.
Correct Answer is A
Explanation
A. The tuberculin test is administered intradermally, and the needle should be inserted at a 15-degree angle to ensure the medication is delivered just under the surface of the skin.
B. A 90-degree angle is used for intramuscular injections, not for intradermal tests like the tuberculin test.
C. A 30-degree angle is commonly used for subcutaneous injections and is too deep for an intradermal injection.
D. A 45-degree angle is also used for subcutaneous injections but is not suitable for intradermal injections.