Which of the following is correct with regard to obtaining a rectal temperature? Because of its invasive nature and risk for injury to rectal mucosa, it is not recommended as the site of first choice Rectal temperature readings are appropriate in all clients if an accurate temperature is needed An oral thermometer may be used to obtain a rectal temperature if necessary A rectal temperature reflects surface temperature
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Which of the following is correct with
regard to obtaining a rectal temperature?
Because of its invasive nature and
risk for injury to rectal mucosa, it is
not recommended as the site of
first choice
Rectal temperature readings are
appropriate in all clients if an
accurate temperature is needed
An oral thermometer may be used
to obtain a rectal temperature if
necessary
A rectal temperature reflects
surface temperature
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- A patient has a fecal impaction. The nurse correctly adminis-ters an oil-retention enema by: a. Administering a large volume of solution (500–1,000 mL)b. Mixing milk and molasses in equal parts for an enemac. Instructing the patient to retain the enema for at least30 minutesd. Administering the enema while the patient is sitting onthe toiletAn elderly patient is confined to bedrest following cervicalspine surgery to treat nerve pinching. The nurse is vigilantabout turning the patient and assessing the patient regularly toprevent the formation of pressure ulcers. What type of agentis the stimulus for pressure ulcers?a. Mechanicalb. Thermalc. Chemicald. ElectricalCalculate the required drip rate for a 6 year old patientundergoing a dental routine. The patient weighs 3.4 kg and otherwisehealthy. The giving set delivers 60 drops/mL.
- Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week.u Hx COPD, cor pulmonaleu It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindingsu Pulse – Regular, rapid…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…
- Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…
- Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…