A nurse performs cardiopulmonary resuscitation (CPR) on a 92-year-old with brittle bones and breaks a rib during the procedure, which then punctures a lung. The patient recovers completely without any residual problems and sues the nurse for pain and suffering and for malpractice. Which key point will the prosecution attempt to prove against the nurse?
The patient would have died if nothing was done.
The CPR procedure was done incorrectly.
The patient was resuscitated according to the policy.
The older patient with brittle bones might sustain fractures when chest compressions are done.
The Correct Answer is B
A. While the patient may have been in a life-threatening situation, this point is not necessarily a direct indictment of the nurse’s actions but rather a justification for performing CPR.
B. The prosecution will likely focus on whether the CPR was performed according to accepted standards of care. If it can be shown that the technique was inappropriate or negligent, this would support the claim of malpractice.
C. Performing CPR according to policy may serve as a defense for the nurse, emphasizing adherence to established protocols.
D. While it is true that older adults with brittle bones may be at risk for fractures, this is a known risk of CPR, and the prosecution will aim to demonstrate specific negligence or failure in technique rather than just acknowledging inherent risks.
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Correct Answer is B
Explanation
A. Performing movements until the patient reports pain is inappropriate in passive range of motion, as the goal is to maintain joint function without causing discomfort.
B. Moving each joint to the point of resistance helps to maintain flexibility and prevent stiffness without causing harm, making this the appropriate technique.
C. Repeating movements five times by the patient is not applicable for passive range of motion, which is performed by the nurse on a patient who cannot do it themselves.
D. While smooth movements are essential, they should not be done quickly; the focus should be on the patient's comfort and safety, avoiding rapid or jerky motions.
Correct Answer is D
Explanation
A. Vision is not commonly affected by vancomycin, so it is not a priority to assess.
B. Heart tones are not directly impacted by vancomycin and do not require immediate monitoring unless there are specific cardiovascular concerns.
C. Bowel sounds are not directly influenced by vancomycin and do not need to be prioritized in this case.
D. Vancomycin is known to be ototoxic, especially in high doses or with prolonged use, so monitoring for signs of hearing loss or tinnitus is essential to prevent potential irreversible damage.