Author Question: The nurse is reviewing documentation for a client from the previous shift. The documentation states, ... (Read 136 times)

KWilfred

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The nurse is reviewing documentation for a client from the previous shift. The documentation states, +1 edema right lower leg. Based on this data, what does the nurse expect when assessing this client?
 
  1. The presence of slight pitting, no obvious distortion.
  2. Deep pitting, obvious distortion.
  3. Pitting is obvious, extremities are swollen.
  4. Moderate amount of edema.

Question 2

The nurse completes a skin assessment for a client and is preparing to document the appearance of herpetic lesions found over a client's nose and mouth region.
 
  Which terms can the nurse use when documenting the skin assessment for this client in the medical record?
  Select all that apply.
  1. Vesicular.
  2. Pustular.
  3. Pruritic.
  4. Ulcerated.
  5. Crusty.



lgoldst9

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Answer to Question 1

Correct Answer: 1

Edema, or accumulation of fluid in the body's tissues, is recorded as +1, +2, +3, or +4. The designation +1 means the client has slight pitting in the right lower leg with no obvious distortion.

Answer to Question 2

Correct Answer: 1, 2, 5
Herpes simplex lesions progress from vesicles to pustules, and then crusts. They are not typically itchy (pruritic). They are not often described as being ulcerated.



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