Author Question: Which entry by the nurse demonstrates the most accurate and safe documentation of patient care? ... (Read 55 times)

ss2343 · **on:** Jul 22, 2018

Which entry by the nurse demonstrates the most accurate and safe documentation of patient care?

a. Sm. amt. of emesis.
b. 150 mL of cloudy dark yellow urine.
c. Had a good day.
d. Looks bad.

Question 2

A patient has been hospitalized for 5 days and has had no visitors. The nurse observes the patient to be bored, restless, and anxious. The nurse identifies this behavior as which of the following?

a. Sensory deficits
b. Sensory overload
c. Sensory deprivation
d. Changes in attitudes

shoemake · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

B
150 mL of cloudy dark yellow urine is the best. The use of precise measurements makes documentation more accurate. To avoid misunderstandings and promote patient safety, write out any abbreviations that are possibly confusing. Avoid using generalized, empty phrases, such as had a good day. Be objective and factual; do not use looks bad because it is vague and too general.

Answer to Question 2

C
Sensory deprivation occurs when inadequate quality or quantity of stimuli impairs a patient's perception. It can cause affective changes (e.g., boredom, restlessness, increased anxiety, emotional lability) and/or perceptual changes (e.g., reduced attention span, disorganized visual and motor coordination, confusion of sleeping and waking states). Sensory deficits such as low vision and blindness are very common forms of disability. When a person receives multiple sensory stimuli, the brain has difficulty distinguishing the stimuli, leading to sensory overload. A person with sensory overload no longer perceives the environment in a way that makes sense. Sensory deprivation can be caused from living in a nonstimulating environment. Ask the patient how to improve the quality of stimulation in the environment.