A nurse is reviewing client information following the evening change-of-shift report. Which of the following client needs should the nurse address first?
A client who has type 2 diabetes mellitus needs assistance counting the carbohydrates in her meal.
A client who has a new tracheostomy is experiencing coughing episodes.
A client who has a BMI of 17 refuses his dinner tray.
A client awaiting discharge needs to demonstrate colostomy care before leaving.
The Correct Answer is B
A. Assisting a client with counting carbohydrates is important for managing diabetes, but it is not an urgent need that must be addressed immediately.
B. A client with a new tracheostomy who is experiencing coughing episodes may indicate a risk for airway obstruction or other complications, making this the most urgent situation that requires immediate intervention.
C. A client with a BMI of 17 who refuses dinner could be concerning for nutritional status, but it is not as critical as addressing potential airway issues with the tracheostomy client.
D. While demonstrating colostomy care is essential for discharge readiness, it can wait until more urgent needs are addressed. Ensuring the client with a tracheostomy is stable is the priority.
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Correct Answer is C
Explanation
A. An abdominal CT scan with contrast typically requires specific informed consent due to the use of contrast material and potential risks associated with it.
B. An esophagogastroduodenoscopy is an invasive procedure that necessitates special informed consent due to its risks and potential complications.
C. The insertion of an NG tube to low intermittent suction is considered a routine procedure that is generally included under the client's general consent for treatment.
D. The administration of fresh frozen plasma involves specific risks and usually requires informed consent because of the implications of blood product administration.
Correct Answer is B
Explanation
A. Keeping the water heater set below 60° C (140° F) is important for preventing scalding but may not be feasible for everyone, as some people prefer hotter water for hygiene.
B. Disposing of unused medications is a critical safety measure to prevent accidental ingestion or misuse, making it the best choice for home safety education.
C. Setting the refrigerator temperature to 7.2° C (45° F) is higher than the recommended maximum of 4° C (40° F) to prevent food spoilage and bacterial growth.
D. Running electrical cords under carpeting poses a fire hazard and should be avoided, thus is not suitable advice for a safety presentation.