Question 1
A patient in the critical care unit demonstrates increasing agitation. What should the nurse use to assess this patient's agitation level? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.◦ Glasgow Scale
◦ Ventilator Adjusted Motor Assessment Scoring Scale
◦ Richmond Agitation-Sedation Scale (RASS)
◦ Reaction Level Scale
◦ Sedation Assessment Scale (SAS)
Question 2
The nurse plans to use music therapy to help reduce a critically ill patient's level of anxiety. What should the nurse do when using this complementary and alternative therapy? Select all that apply.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.◦ Ensure that the music beats are between 60 to 80 per minute.
◦ Play the music from a CD player on the bedside table.
◦ Ask family members to identify the patient's preferred music.
◦ Listen to the music in advance to make sure it does not have lyrics.
◦ Plan for the music to be played for 30 uninterrupted minutes.
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