1. A nurse is about to give an oral medication to a client in a shared room. Which action best confirms the client's identity?
Check the name on the room door and bed
Ask the client to state full name and date of birth and compare with the wristband and medication record
Ask the client, 'Are you Mr. Ahmed?'
Confirm identity with the client's visitor
显示答案
B. Ask the client to state full name and date of birth and compare with the wristband and medication record
Two patient-specific identifiers, stated by the client and matched against the wristband and the record, are the standard. Room or bed numbers are never identifiers, and closed questions invite a false 'yes'.
2. A patient with life-threatening asthma has just been intubated. Over several minutes his blood pressure falls sharply and the ventilator shows that each breath starts before the previous exhalation has finished. What should the nurse expect the team to do?
Increase PEEP to the maximum to keep the airways open
Give a large dose of sedation before checking the ventilator
Briefly disconnect the ventilator to let trapped air escape, then reduce the breathing rate
Increase the respiratory rate on the ventilator so that carbon dioxide is cleared from the lungs faster
显示答案
C. Briefly disconnect the ventilator to let trapped air escape, then reduce the breathing rate
In severe bronchospasm, exhalation is prolonged. If the next breath begins too early, air is trapped (breath stacking or intrinsic PEEP). Rising intrathoracic pressure reduces venous return and can cause severe hypotension or cardiac arrest. Disconnecting briefly, often with gentle chest compression, lets the trapped gas escape, and a slower rate with a longer expiratory time prevents recurrence. Increasing the rate or PEEP worsens trapping. Sedation does not address the mechanical problem.
3. Before giving an oral medication, how should the nurse identify an alert, oriented patient?
Ask the patient to state their name and date of birth and check the wristband
Check the bed number against the patient list at the nurses' station
Rely on recognising the patient from the earlier medication round
Ask, 'Are you Mr Mensah?' and check that the patient nods in agreement
显示答案
A. Ask the patient to state their name and date of birth and check the wristband
Safe identification uses at least two identifiers, such as full name and date of birth, which the patient states in response to an open question and the nurse checks against the wristband and prescription. A closed question invites a confused or anxious patient to agree with the wrong name. Bed numbers change when patients move and are never identifiers. Familiarity is unreliable and is a common cause of wrong-patient errors.
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