The patient has been diagnosed with diabetes. When admitted, the patient is unkempt and is in need of a bath and foot care. When questioned about hygiene habits, the nurse learns the patient takes a bath once a week and a sponge bath every other day. To provide ultimate care for this patient, which principle should the nurse keep in mind?
All cultures value cleanliness with the same degree of importance.
Patients who appear unkempt place little importance on hygiene practices.
The patient’s illness may require teaching of new hygiene practices.
Personal preferences determine hygiene practices and are unchangeable.
The Correct Answer is C
A. Cultural values regarding cleanliness vary, so it is inaccurate to assume uniform standards.
B. Judging the patient as placing "little importance" on hygiene due to appearance can lead to biases and does not consider the patient’s routine.
C. Diabetes may necessitate changes in hygiene practices, especially regarding foot care, to prevent complications. Education on optimal hygiene practices is essential for health management in diabetic patients.
D. While personal preferences influence hygiene, they can be adapted with appropriate education and guidance when necessary for health reasons.
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Correct Answer is B
Explanation
A. Increasing activity level may be unrealistic for a patient on strict bed rest due to a pelvic fracture.
B. Repositioning every 2 hours is a realistic and achievable goal for a patient on bed rest to prevent complications such as pressure ulcers and maintain circulation.
C. Using a walker for ambulation may not be feasible immediately after a pelvic fracture.
D. Transferring with a sliding board may not be safe or appropriate in the early stages post-injury, especially if bed rest is required.
Correct Answer is C
Explanation
A. Increased cholesterol levels are not directly related to garlic intake or the effects of warfarin.
B. Distended jugular veins may indicate fluid overload or heart failure but are not a direct concern related to warfarin and garlic interaction.
C. Garlic can enhance the anticoagulant effect of warfarin, increasing the risk of bleeding; therefore, monitoring for signs of bleeding is crucial.
D. Angina is not a direct consequence of the interaction between garlic and warfarin and does not specifically relate to the assessment for this patient.