Author Question: According to the phlebitis scale, pain and erythema at the access site with streak formation would ... (Read 26 times)

jayhills49

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According to the phlebitis scale, pain and erythema at the access site with streak formation would be documented as which of the following grades?
 
  a. 1
  b. 2
  c. 3
  d. 4

Question 2

A patient requests the nurse's assistance to the bedside commode and becomes frustrated when unable to void in front of the nurse. The nurse understands the patient's inability to void because
 
  a. Anxiety can make it difficult for abdominal and perineal muscles to relax enough to void.
  b. The patient does not recognize the physiological signals that indicate a need to void.
  c. The patient is lonely, and calling the nurse in under false pretenses is a way to get attention.
  d. The patient is not drinking enough fluids to produce adequate urine output.



peilian

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Answer to Question 1

C

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A A grade of 1 would indicate erythema at the access site with or without pain.
B There is no grade 2 on the phlebitis scale.
C A grade of 3 would indicate pain at the access site with erythema, edema, or both; streak formation; and palpable venous cord.
D A grade of 4 would indicate pain at the access site with erythema, edema, or both; streak formation; palpable venous cord; and purulent drainage.

Answer to Question 2

A
Attempting to void in the presence of another can cause anxiety and tension in the muscles that make voiding difficult. The nurse should give the patient privacy and adequate time if appropriate. No evidence suggests that an underlying physiological or psychological condition exists.



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