A nurse is responding to a call light and finds a client lying. I think I may have pulled it out. The nurse answers a patient's call light and finds the patient sitting up in bed and requesting pain medication. Other actions like notifying the provider and clearing the area of hazardous objects would take place A nurse walking down the hospital corridor hears a call for help from a client who was admitted with vascular insufficiency. Client fell out of bed, but did push the call button for assistance. offering self means when she offers herself …. Which of the following actions should the nurse take first? a. Lock the remaining Fluid resuscitation was completed, burns were dressed with a low-adherent silver dressing, and the client ’ s pain has effectively been managed with intravenous analgesics. This priority ensures immediate safety and the evaluation of the client's health condition following the fall. 2 However, a study in four U. What does the nurse tell the assistant to be especially vigilant for?, The nurse answers a client's call light and realizes that the client has an upper Study with Quizlet and memorize flashcards containing terms like 1. Which. Based on the documentation shown in the exhibit, the nurse made an incorrect entry in the client's medical record at what time? Click on the exhibit button for additional information. " The nurse determines that the intravenous (IV) catheter has been almost completely pulled out of the insertion site. Exhibit 1: Nurses' Notes: 1000: Client states, "I am unable to eat anything without vomiting. I, The nurse assessing a client understands that which of the Study with Quizlet and memorize flashcards containing terms like A nurse enters a client's room and finds that the client is lying on the floor. Take a full set chapter 26. Client states, "l fell out of bed while -Provide the client with written information about the phases of loss & grief. Which action should the nurse take first? a. Which chart entry should the nurse document for this finding? Study with Quizlet and memorize flashcards containing terms like A nurse answers a call light and finds a client anxious, short of breath, reporting chest pain, and having a blood pressure of 88/52 mm Hg on the cardiac monitor. Call for another nurse aide. Study with Quizlet and memorize flashcards containing terms like A nurse assesses a client for pupillary response of the eyes and finds a unilateral dilated pupil that is unresponsive to light or accommodation. The nurse then informs the physician and the nursing supervisor about this incident and also completes an incident report. The nurse calls the registered nurse, who checks the client and then calls the nursing supervisor and the primary health care provider to inform them of the occurrence. cut the food into bite-size pieces. wash his or her hands and the client's hands. Provide comfort measures to the patient. hypoglycemia. 3. The nurse estimates that at least 2 minutes have passed since the client's light first came on. What information should be included? A. Which of the following actions should the nurse take first? check the client for injuries move hazardous objects away from the client notify the provider ask the client to describe how she felt prior to the fall A nurse is responding to a call light and finds a client lying on the bathroom floor. The nurse can assume the source of the blood is likely from the. What is the nurse's priority action in this situation?, An Indian The nurse aide finds a conscious client lying on the bathroom floor. Decontaminate the client's clothing. (Chapter 12) (Chapter 43) A nurse is responding to a call light and finds a client lying on the bathroom floor. C) Notify the provider. Assess the client's lung sounds. Decontaminate the open wound on the client's thigh. Call the Poison Control Center. when the nurse performs the Study with Quizlet and memorize flashcards containing terms like You walk into the dining room. The client reports falling while trying to go to the restroom. The 62-year-old client who is complaining that no one answered the call light for2 hours yesterday. Wear an N95 mask when caring for the client. Sep 19, 2023 · Study with Quizlet and memorize flashcards containing terms like A nurse responds to the call bell and finds another nurse evacuating the client from the room, which has caught fire. call for assistance form the nurse in charge C. Frequent hand washing is the first line to prevent the spread of infection. Place a trash can for soiled linens inside the client's room. The FIRST thing the nurse aide should do is what, What is choking and more. , A nurse is caring for a client who is postoperative following a knee arthroplasty & requires the use of thigh-length sequential compression sleeves. Notify the provider immediately. Which of the following actions should the nurse take first? A: Check the client for injuries B: Move hazardous objects away from the client C: Notify the provider D: Ask the client to describe how she felt propr to the fall A nurse is responding to a call light and finds a client lying on the bathroom floor. What is the FIRST thing you should do?, The nurse aide finds a conscious client lying on the bathroom floor. A) Check the client for injuries. Which of the following actions should the nurse take? Dec 3, 2023 · The nurse aide finds a conscious client lying on the bathroom floor. What is the first action the nurse should implement?, The nurse is discussing infection control guidelines with a coworker Find step-by-step Psychology solutions and your answer to the following textbook question: The nurse finds a client with schizophrenia lying under a bench in the hall. Notify the Rapid Response Team. A nurse answers a call light and finds a client anxious, short of breath, reporting chest pain, and having a blood pressure of 88/52 mm Hg on the cardiac monitor. Exhibit: 1700 Found client lying on floor next to bed. offer the client a drink of water D. * B Provide for personal space. Refer the client to smoking cessation classes. Study with Quizlet and memorize flashcards containing terms like The nursing assistant has taken vital signs of the ventilated postoperative client who has had radical neck surgery. The FIRST thing the nurse aide should do is. Which of the following actions should the nurse take? 1. Shout for the code 6) A nurse is responding to a call light and finds a client lying on the bathroom floor. 1 day ago · A nurse is responding to a call light and finds a client lying on the bathroom floor. D. B. Which is the priority action of the nurse? 1. Decontaminate the examination room the client is placed in. ' The nurse determines that the intravenous (IV) catheter has been almost completely pulled out of the insertion site. The nurse makes the client comfortable on the bed and completes an assessment. Identify the sequence in which the nurse should perform the following steps. A depressed client is found unconscious on the floor in the dayroom. After a thorough assessment and appropriate care, the nurse completes an incident report. of the following actions should the nurse take first? ANS: Check the client for injuries. May 22, 2024 · A nurse is respond to a call light and finds a client lying on the bathroom floor. 1. Which of the following assessments should the nurse use to identify the clients safety needs?, A nurse is responding to a call light and finds a client lying on the bathroom floor. Notify the provider. call for assistance from the nurse in charge. Study with Quizlet and memorize flashcards containing terms like A nurse is preparing to administer an injection of an opioid medication to a client. butter the client's bread. This is a popular solution! Jul 6, 2023 · Reassure the client that this is an expected response to grief 9-A nurse is responding to a call light and finds a client lying on the bathroom floor. When the ventilator sounds an alarm, the nurse finds the client lying in bed holding the endotracheal tube in his hand. Take a full D. Fluid Peptic Ulcer Disease / Gastrointestinal BleedingA 6 2 - year - old female client was admitted to a medical - surgical unit yesterday with partial - thickness burns to her right forearm secondary to a When the ventilator alarm sounds, the nurse finds the patient lying in bed holding the endotracheal tube (ET). Click the card to flip 👆. A client with no known risk factors for this disorder should be referred for A client has a nasogastric (NG) tube after a Nissen fundoplication. 5 4 of A nurse finds an adult client lying unconscious & unresponsive on the bathroom floor. Notify the pharmacy when wasting the medication 3. Notify the provider d. Provide reassurance to the client. C Stand in the doorway. 12) When responding to a client's call light, the nurse The client is at high risk for choking. c. __A. Call for help to get the client back in bed. What can i do to help you is an example of an open ended question, as the nurse is expecting an answer from the client which is usually more than a word. D) Ask the client to describe how she felt prior to the fall. Which actions by the nurse indicates correct Charting the client's response to pain medication take n Making a late entry regarding a client's request for pain medication. ask the client to describe how she felt prior to the fall The nurse should assess the catheter's placement and potential for blockage due to the reduced output. The nurse shouldidentify that which of the following findings requires further intervention?8. A conscious resident has his hands to his throat and is making no sounds. When assisting a client with eating, one of the first things the nurse aide should do is. The nurse is responding to a client's call light. notify the provider d. Check the orders and give the patient the requested pain medication. " What is the best response by the nurse? 1. _____B. Try to figure out the number of pills taken. The nurse answers the call light and finds the client vomiting bright red blood with the NG tube lying on the floor. Call for additional help or assistance to ensure the client's safety and obtain necessary support. After determining that the client is unresponsive, the nurse should perform which actions? Place the actions the nurse should take in the appropriate order. Move hazardous objects away from the client. , A client The nurse finds the client lying on the floor. When responding to a call light, the nurse finds a client lying on the floor, with the bed linens around the legs. tance and examining the patient for injury, the nurse helps. Study with Quizlet and memorize flashcards containing terms like A nurse answers a call light and finds a client anxious, short of breath, reporting chest pain, and has a blood pressure of 88/52 mm Hg. Fluid resuscitation was completed, burns were dressed with a low-adherent silver dressing, and the client’s pain has effectively been managed with intravenous analgesics. Assist the client back to bed. A nurse in a long-term care facility is caring for a client who dies during the nurse’s shift. The nurse is answering a patient ’ s call light. Which of the following assessments should the nurse use to identify the client's safety needs ? ( Select all that apply . S. move hazardous objects away from the client c. What Study with Quizlet and memorize flashcards containing terms like 1. Nursing. Which of the following actions should the nurse take first? -Check the client for injuries. Bruising noted on client's abdomen. The nurse recognizes that which cranial nerve is responsible for the damage of pupillary response? a. b. Client became tangled in the bed linens, then called for assistance after falling out of bed. " 2. "I didn't hear anyone talking; come with me to your room. Fluid resuscitation was completed, burns were dressed with a lowadherent silver dressing, and the client's pain has effectively been managed with intravenous analgesics. Ask the client to describe how she felt prior to the fall Term 44 of 58 A nurse is responding to a call light and finds a client lying in the bathroom floor. The nurse answers a client's call light. What will the nurse do first? a. ) The nurse assesses a client 8 hours after having a total abdominal hysterectomy. The client was found lying on the floor. The client states, "I was getting out of bed and caught my IV on the side rail. Assess the clients lung sounds. A. The client states, 'I was getting out of bed and caught my IV on the side rail. III c. When answering the call light for a client on bedrest, the nurse finds the client's visitor unconscious on the floor with no discernable pulse and not breathing. Encourage the client to walk 5 minutes each hour. The 45-year-old client who complained of having chest pain at midnight last nightand received NTG sublingually. States that pain is a "7" on a 0 to 10 pain scale. answer the call light when the aide has the time. Perform CPR. She finds the client lying on the floor. Oct 19, 2023 · The nurse should take the following actions FIRST when responding to a call light and finding a client on the bathroom floor: Assess the client's condition and determine if there are any immediate medical needs or safety concerns. hypothyroidism. 26. The nurse is answering a patient’s call light. Which of the following actions should the nurse take? Fluid resuscitation was completed, burns were dressed with a low-adherent silver dressing, and the client’s pain has effectively been managed with intravenous analgesics. This morning, a nurse responds to the client's call light and finds the client lying on her side with an emesis basin filled with coffee-ground vomitus. The nurse assesses the client for possible symptoms of: hypocalcemia. 7) A nurse is caring for a client who is expressing anger over his diagnosis of colorectal. Which finding will the nurse identify as an early sign of shock? Which of the following actions should the nurse take? 21. , Nurse Channing is caring for four clients and is preparing to do his initial rounds. The 29-year-client diagnosed with septicemia who called to request more Audience Response System. Notify the surgeon. a. Dec 27, 2022 · Fluid resuscitation was completed, burns were dressed with a low-adherent silver dressing, and the client’s pain has effectively been managed with intravenous analgesics. Study with Quizlet and memorize flashcards containing terms like Which of the following is a neurological complication that may occur when a vast restraint is too tight around a patients body?, Upon entering a client's room, the nurse finds the client lying on the floor. When the nurse enters the room, she notices a woman lying on the floor. Which action is most appropriate? A. Client is pale and diaphoretic. ___. hypokalemia. When assisting a client in learning how to use a cane, the nurse aide stands. Ask the client to describe how she felt prior to the fall. When responding to the call bell, the nurse finds the client lying on the floor. Ask another nurse to observe the medication wastage 2. Which statements accurately describe aspects of this proce-. The client shouts, "What took you so long to get in here!" Which action should the nurse implement? * A Request backup from the staff. Study with Quizlet and memorize flashcards containing terms like A nurse is assessing an older adult client's risk for falls . What action by the nurse takes priority? a. Check the client for injuries. the patient back to bed and then fills out an incident report. Save the client's vomitus for analysis by the radiation safety staff. The patient informs the nurse the visitor was standing near the bedside table and suddenly collapsed, hitting her head on the bedside table. A nurse is responding to a call light and finds aclient lying on the bathroom floor. Which action would be The nurse answers a patient's call light and finds the patient sitting up in bed and requesting pain medication. help the client into a sitting position B. After assessing the client and notifying the health care provider, what client information should the nurse document on the incident report? States nursing staff did not respond to call light Tripped while rushing to the bathroom to avoid incontinence Found lying on floor at foot of bed Fell while walking to the bathroom While making rounds at 4:00am, a nurse aide finds a patient lying on the floor. The nurse finds several empty bottles of a prescribed tricyclic antidepressant lying near the client. The nurse assesses the client and notifies the physician of the incident. Study with Quizlet and memorize flashcards containing terms like When answering the call light for a client on bedrest, the nurse finds the client's visitor unconscious on the floor with no discernable pulse and not breathing. 29. the nurse receives report about a client who has 0. Which of the following actions should the nurse take first? A. ANSWER THE CALL LIGHT AND GET THE URINAL. 12)The correct answer is using open ended questions. Which of the following actions should the nurse perform first? A. The FIRST thing the nurse aide should do is: A. Take a full set A nurse in a long-term care facility enters a client's room and finds the client lying on the floor. A nurse is responding to a call light and finds a client lying on the bathroom floor. on the floor by the bathroom door. Tell the client that sometimes no cause for disease is found. The client reports an irritating tickling sensation in the throat, a salty taste, and a burning sensation in the chest. Rank in order of priority. Which action should the nurse take?, A nurse smells smoke and subsequently discovers a fire in a garbage can in a common area on the hospital unit. D) Ask the client to describe how she felt prior to the fall. Which of the following actions should the nurse take first? Check the client for injuries A nurse is responding to a call light and finds a client lying on the bathroom floor. Move hazardous objects away from the client c. After classroom discussion regarding confidentiality policies and laws protecting client records, a student asks why its permissible for them to review Which action should the nurse take first?Call for assistance. The correct answer is D. cancer. Dec 4, 2023 · When responding to the call bell, the nurse finds the client lying on the floor. Study with Quizlet and memorize flashcards containing terms like A nurse is assessing an older adult clients risk for falls. A nurse answers a clients call light and finds the client in the bathroom, vomiting large amounts of bright red blood. Initiate CPR with chest compressions. * D Encouage the client to sit down The client lives with her husband, has two adult children, and a history of rheumatoid arthritis for which she is prescribed celecoxib. Chapter 41: Fluid, Electrolyte, and Acid-Base Balance FON. ignore the light, since he is not the aide's own client. Which chart entry should the nurse document for this finding? 1. The client fell out of bed. What information should the nurse chart on the incident report form? A. Assess the client's carotid pulse and assess if the client is breathing B. " Client reports pain in left upper quadrant of abdomen that radiates to their back. Check the client for injuries b. Take a set of vital signs. ask the client to describe how she felt prior to the fall 7. Which of the following actions should the nurse take first A nurse is responding to a call light and finds a client lying on the bathroom floor. Upon further assessment, the nurse notes a tissue with bright red, frothy blood at the bedside. -which of the following actions should the nurse identify as an indication of correct use? -the client holds the cane on the stronger side of her body. What is the nurse's priority action? A. Put on a pair of gloves. Assess the patient's pain and pain level. 9% sodium chloride infusing IV at 125 mL/hr. After calling for assis-. Check for apical pulse. V d. Rationale : The first action the nurse should take when using the nursing process is to assess the client for injuries. Remove the mask when leaving the client's room. Initiate CPR with chest The nurse finds a client on the floor in the client's room. 3 While 49% of the nurses viewed call lights as a patient-safety issue, 53% viewed answering call lights as an interruption to critical aspects of their May 8, 2023 · The first action a nurse should take when they find a client lying on the bathroom floor is to check the client for injuries. What will the nurse do first? Click the card to flip 👆. Give 2 rescue breaths. What action should the nurse take first? a. Which of thefollowing actions should the nurse take first?9. Which action should the nurse take first? A) Offer reassurance to the patient B) Activate the hospital's rapid response team C) Call the healthcare provider to reinsert the tube D) Manually ventilate the patient with 100% oxygen A nurse answers a patient’s call light and finds the patient. Which of the following actions should the nurse take first? . Make sure 2 fingers can fit under the sleeve. II b. This morning, a nurse responds to the client ’ s call light and finds the client lying on her side with an emesis basin filled with coffee-ground vomitus. A nurse is assessing an adult client who has beenimmobile for the past 3 weeks. What should she or he do first? A. C) Notify the provider D) Ask the client to describe how she A nurse is responding to a call light and finds a client lying on the bathroom floor. * D Encouage the client to sit down A nurse is caring for a client who has just had an endotracheal tube advanced airway inserted and is being oxygenated by a ventilator. 2. How should the nurse proceed in Management of call light activity is largely driven by the nursing staff. Take a full set of vital signs. May 28, 2021 · ATI Fundamentals Test A 1. The nurse draws out 1 mL of the medication from a 2 mL vial. 22. Which of the following actions should the nurse take first?, A nurse is initiating a How should the nurse respond to this clients request? Records are used in educational settings and for learning purposes, but the student is bound to hold all information in strict confidence. Establish Examine personal values about the issue. A client age 80 years, who takes diuretics for management of hypertension, informs the nurse that she takes laxatives daily to promote bowel movements. Study with Quizlet and memorize flashcards containing terms like A nurse answers a call light and finds a client anxious, short of breath, reporting chest pain, and having a blood pressure of 88/52 mm Hg on the cardiac monitor. check for signs of injury Q-Chat. ), nurse is responding to a call light and finds a client lying on the bathroom floor . Call 911/000. announce on the intercom that there are two patients ahead of him. Assess the patient's vital signs. Reinsert the NG tube. Which of the following actions should the nurse take first? Terms in this set (57) a nurse is evaluating a client's use of a cane. Nurse Janus enters a room and finds a client lying on the floor. -Reassure the client that this is an expected response to grief. d. hospitals revealed varied opinions among staff regarding patient's use of call lights. B) Move hazardous objects away from the client. * D Encouage the client to sit down Renin. The nurse must assess the client's ability to swallow and any change in the client's status. Study with Quizlet and memorize flashcards containing terms like The nurse enters a client's room and finds the client lying on the ground. Which of the following actions should the nurse take first? A) Check the client for injuries. The client climbed over the side rails. Which of the following actions should the nurse take first? Answer: Check the client for injuries. The nurse must be ready to respond if the client chokes. The nurse completes the incident report for which purpose. SLIGHTLY BEHIND THE CLIENT ON THE WEAK SIDE. Take a full Here’s the best way to solve it. Which of the following actions should the nurse take first A nurse is caring for a client who has pancreatitis. Place the client in an negative airflow room. When responding to a call light, the nurse finds a client with aggressive behaviors pacing and restless in the room. check the client for injuries b. This morning, a nurse responds to the client’s call light and finds the client lying on her side with an emesis basin filled with coffee-ground vomitus. C. The client says, "God told me to lie here. Science. Question 18 When responding to a call light, the nurse finds a client lying on the floor, with the bed linens around the legs. Regin chest compressions. Nursing questions and answers. C) Notify the provider . c Factor V Leiden is an inherited thrombophilia that can lead to abnormal clotting events, including PE. Expert Solution. Which action should the nurse take?, A nurse is preparing to provide care to a client who is receiving radiation therapy for cancer; the radiation source will be kept in the client's room. Study with Quizlet and memorize flashcards containing terms like A nurse responds to the call bell and finds another nurse evacuating the client from the room, which has caught fire. ___C. jl ad ts oy iu rl le dw df kf