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Author Question: The nurse is preparing to document care provided to the client during the day shift. The nurse ... (Read 73 times)

segrsyd

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The nurse is preparing to document care provided to the client during the day shift. The nurse documents that the client experienced an increased pain level while ambulating which required an extra dose of pain medication; took a shower; visited with fami
 
  Which information is important to include during the oral end-of-shift reporting?
  Select all that apply.
  A) The extra dose of pain medication
  B) The client's visit with family
  C) The client's response to ambulation
  D) The last antibiotics given
  E) The client's taking a shower

Question 2

The nurse is assigned to provide care to a client who is diagnosed with chronic obstructive pulmonary disease (COPD).
 
  Overnight, the client's oxygen saturation levels decreased and the client was placed on oxygen by the respiratory therapist. To review specific information about the care received from the respiratory therapist, which portion of the medical record will the nurse review?
  A) The consultation report
  B) The nurses' notes
  C) The medication record
  D) The diagnostic report



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Zebsrer

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Answer to Question 1

Answer: A, C

In order to provide for the client's safety, the nurse would pass on the client's response to ambulation so that the oncoming staff can take fall precautions. The nurse would also report any as-needed medications given and when they were last given. Visiting with the family need not be mentioned at change of shift but should be documented. Taking a shower does not need to be reported, only documented. Antibiotics are reflected on the medication administration record (MAR).

Answer to Question 2

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