Following a code, the nurse assigned to the client will document ...

[SO00]

Following a code, the nurse assigned to the client will document the events. Which items should the nurse include along with the written documentation of the event?
 
  Select all that apply.
 
  1. The rhythm strip
  2. The form used to record the medications and interventions that occurred during the code
  3. The DNR record
  4. Notification of the family
  5. Client response and transfer location, if indicated

Question 2

The nurse is caring for a conscious adult client with an obstructed airway. When performing abdominal thrusts, which action by the nurse is appropriate?
 
  1. Making a fist with one hand, with the thumb on top, and placing the thumb just below the xiphoid process
  2. Using the side of the hand and placing it just above the xiphoid process
  3. Grasping the fist with the other hand and placing the flat of the hand into the client's abdomen
  4. Making a fist with one hand, tucking the thumb inside the fist, grasping the hand with the other fist, and pushing the fist above the victim's navel and below the xiphoid process

[TheNamesImani]

Answer to Question 1

Correct Answer: 1,2,4,5

The rhythm strip can be mounted or attached to the record, depending on facility policy. Most agencies have a form used during the code allowing the staff to document medications, procedures, lab values, and other data performed or obtained during the code, and this should be signed and included in the medical record. If a code was performed, there should not be a DNR, or do-not-resuscitate, record. The nurse should document what support people were notified and their response, as well as the disposition of the client.

Answer to Question 2

Correct Answer: 4

The nurse should make a fist with one hand and tuck the thumb inside the fist to avoid injuring the client. The other hand grasps the fist, which is pushed into the abdomen above the navel and below the xiphoid process. The other options would injure the client, and demonstrate incorrect technique.