An obstetric nurse comes across an automobile accident. The driver seems to have a crushed upper airway, and while waiting for emergency medical services to arrive, the nurse makes a cut in the trachea and inserts a straw from a purse to provide an airway. The patient survives and has a permanent problem with vocal cords, making it difficult to talk. Which statement is true regarding the nurse's performance?
The nurse stayed within the guidelines of the Good Samaritan Law.
The nurse acted appropriately and saved the patient's life.
The nurse should have just stayed with the patient and waited for help.
The nurse took actions beyond those that are standard and appropriate.
The Correct Answer is D
A. The Good Samaritan Law typically protects individuals who provide care in emergency situations but may not apply if the actions taken are beyond the standard of care or are not in the nurse's training.
B. While the nurse's intention was to save the patient's life, the method employed was not a recognized standard procedure for airway management and may have caused harm.
C. Waiting for help may not have been an appropriate option if the patient's airway was compromised, but the method employed by the nurse was not advisable.
D. Cutting into the trachea and using a straw as a makeshift airway are actions that exceed the typical scope of nursing practice and could be deemed inappropriate, regardless of the outcome for the patient.
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Correct Answer is D
Explanation
A. Chest physiotherapy is used to mobilize secretions and improve lung function, not specifically for increasing stroke volume or preload.
B. Diuretics would decrease preload by removing excess fluid, which is counterproductive in a patient with inadequate stroke volume related to decreased preload.
C. Vasodilators can further decrease preload and are not appropriate in this scenario where preload needs to be increased.
D. Intravenous (IV) fluids are administered to increase preload and improve stroke volume by enhancing the circulating blood volume.
Correct Answer is B
Explanation
A. Atelectasis is prevented primarily through deep breathing exercises and respiratory interventions, not passive ROM.
B. Passive ROM and splinting help prevent joint contractures by maintaining joint mobility and alignment, so the absence of contractures indicates successful prevention.
C. Pressure ulcers are avoided through regular repositioning and skin care rather than passive ROM alone.
D. Renal calculi are primarily prevented through hydration and diet, not passive ROM or splinting.