A nurse is assisting with the care of a client who has infective endocarditis. Which of the following manifestations should the nurse identify as a complication of this disorder?
Dyspnea
Fever
Petechiae
A heart murmur
The Correct Answer is A
A. Dyspnea can indicate heart failure or embolic events resulting from infective endocarditis, making it a serious complication that warrants attention.
B. Fever is a common symptom of infective endocarditis due to the infection but is not a complication; rather, it is part of the disease process.
C. Petechiae are small red or purple spots that can occur with infective endocarditis but are also not considered a complication, rather a manifestation of the condition.
D. A heart murmur may be present due to valvular damage but is not classified as a complication; it is a common finding in infective endocarditis.
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Correct Answer is B
Explanation
A. Using a thermometer to check the temperature of bath water is important for clients with PVD to prevent burns, indicating that this statement reflects understanding.
B. Wearing stockings with elastic tops is not recommended for clients with PVD as they can restrict blood flow and exacerbate symptoms. This indicates a need for further teaching.
C. The statement about not going barefoot is correct, as it helps prevent injury, which is crucial for clients with PVD.
D. Avoiding crossing legs is a proper action to promote circulation and prevent vascular complications, showing the client’s understanding of their condition.
Correct Answer is A
Explanation
A. Providing a consistent daily routine helps reduce confusion and anxiety in clients with dementia, aiding in their orientation and functioning.
B. Allowing the client to choose activities can lead to frustration or confusion if they are unable to remember options or make decisions, thus requiring structure.
C. Using an overhead loudspeaker may confuse the client and is not effective for communication; it is often better to provide information in person.
D. Posting a written schedule can be helpful but should be combined with a consistent routine for optimal understanding and orientation. Providing a structured environment is crucial for clients with dementia.