The nurse observes a loop of bowel protruding from the surgical ...

[Melani1276]

The nurse observes a loop of bowel protruding from the surgical incision. The nurse's initial intervention should be to:
 
  a. call the RN.
  b. cover the bowel with a sterile saline dressing.
  c. turn the patient to the side of the evisceration.
  d. raise the patient up to a high Fowler's position.

Question 2

When using the data, action, response, education (DARE) system of charting, the data portion focuses on:
 
  a. planning.
  b. assessment.
  c. implementation.
  d. patient teaching.

[wilsonbho]

Answer to Question 1

B
Although the RN must be notified, covering the loop of bowel takes priority. The patient may be raised to a semi-Fowler's position to relieve strain on the suture line.

Answer to Question 2

B
DARE is the acronym for four different aspects of charting using the focus format. Data (D) is both subjective and objective and is equivalent to the assessment step of the nursing process. Action (A) is a combination of planning and implementation. Response (R) of the patient is the same as evaluation of effectiveness. Some facilities include education/patient teaching (E).

[Melani1276]

Thank you

[wilsonbho]

No problemo