This topic contains a solution. Click here to go to the answer

Author Question: A nurse is monitoring a client after moderate sedation. The nurse documents the client's Ramsay ... (Read 111 times)

swpotter12

  • Hero Member
  • *****
  • Posts: 527
A nurse is monitoring a client after moderate sedation. The nurse documents the client's Ramsay Sedation Scale (RSS) score at 3. What action by the nurse is best?
 
  a. Assess the client's gag reflex.
  b. Begin providing discharge instructions.
  c. Document findings and continue to monitor.
  d. Increase oxygen and notify the provider.

Question 2

The circulating nurse is in the operating room and sees the surgeon don gown and gloves using appropriate sterile procedure. The surgeon then folds the hands together and places them down below the hips. What action by the nurse is most appropriate?
 
  a. Ask the surgeon to change the sterile gown.
  b. Do nothing; this is acceptable sterile procedure.
  c. Inform the surgeon that the sterile field has been broken.
  d. Obtain a new pair of sterile gloves for the surgeon to put on.



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

kaylee05

  • Sr. Member
  • ****
  • Posts: 318
Answer to Question 1

ANS: C
An RSS score of 3 means the client is able to respond quickly, but only to commands. The client has not had enough time to fully arouse. The nurse should document the findings and continue to monitor per agency policy. If the client had an oral endoscopy or was intubated, checking the gag reflex would be appropriate prior to permitting eating or drinking. The client is not yet awake enough for teaching. There is no need to increase oxygen and notify the provider.

Answer to Question 2

ANS: C
The surgical gown is considered sterile from the chest to the level of the surgical field. By placing the hands down by the hips, the surgeon has broken sterile field. The circulating nurse informs the surgeon of this breach. Changing only the gloves or only the gown does not restore the sterile sections of the gown. Doing nothing is unacceptable.





 

Did you know?

Nearly 31 million adults in America have a total cholesterol level that is more than 240 mg per dL.

Did you know?

Computer programs are available that crosscheck a new drug's possible trade name with all other trade names currently available. These programs detect dangerous similarities between names and alert the manufacturer of the drug.

Did you know?

Approximately one in four people diagnosed with diabetes will develop foot problems. Of these, about one-third will require lower extremity amputation.

Did you know?

For high blood pressure (hypertension), a new class of drug, called a vasopeptidase blocker (inhibitor), has been developed. It decreases blood pressure by simultaneously dilating the peripheral arteries and increasing the body's loss of salt.

Did you know?

Persons who overdose with cardiac glycosides have a better chance of overall survival if they can survive the first 24 hours after the overdose.

For a complete list of videos, visit our video library