Which patients will the nurse determine are in most need of regular perineal care? (Select all that apply.)
A patient who has an indwelling catheter
A patient with urinary and fecal incontinence
A patient with rectal and genital surgical dressings
A bariatric patient
A circumcised male who is ambulatory
Correct Answer : A,B,C,D
A. A patient with an indwelling catheter requires regular perineal care to prevent infection due to increased risk from the catheter.
B. Urinary and fecal incontinence increase the risk of skin breakdown and infection, necessitating frequent perineal care.
C. Surgical dressings in the rectal and genital areas require perineal care to maintain hygiene and prevent wound contamination.
D. Bariatric patients often need regular perineal care due to skin folds and increased risk of moisture-related skin breakdown.
E. A circumcised, ambulatory male typically has a lower risk of infection and may not require as frequent perineal care unless other factors are present.
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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. 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.