Author Question: An older adult patient has been casted for a fractured left wrist. Which action by the nurse takes ... (Read 41 times)

serike · **on:** Jul 11, 2018

An older adult patient has been casted for a fractured left wrist. Which action by the nurse takes priority?

a. Assessing capillary refill in the nail beds of the fingers of the left hand.
b. Instructing the patient on how to effec-tively rate pain on the pain scale.
c. Teaching the patient to wrap the cast in plastic when the patient showers.
d. Providing the patient with a pro-tein-enriched milkshake as a bedtime snack.

Question 2

An older cognitively impaired adult patient is being discharged to a daughter's home. The nurse knows continued success of the patient's bladder training for urinary incontinence primarily rests on the

a. patient's ability to follow instructions.
b. severity of the impairment of the urinary sphincter.
c. patient's ability to sense the need to uri-nate.
d. daughter's ability to support the training.

phuda · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

A
Excessive constriction caused by the cast could result in compartment syndrome, leading to ischemia and tissue destruction of the extremity. Any change in capillary refilling, skin color, skin temperature, or excessive pain not controlled with medication should be immediately reported to the physician. This is the priority assessment. Pain is another important assessment, but circulatory status is first. The other actions are appropriate but not the priority.

Answer to Question 2

D
Treating urinary incontinence in individuals with cognitive impairment requires the use of other behavioral techniques that depend on the caregiver rather than the patient. The success of the techniques in large part depends on the availability and motivation of the caregiver. The other actions are not as important for the cognitively impaired person's success.