Fundamental Case Study Essay examples

3534 Words Jan 20th, 2014 15 Pages
1. Mr. Dunner is admitted to his room accompanied by his wife. Before the nurse can begin the admission assessment, Mr. Dunner states that he needs to “throw up.” The nurse helps him sit up and provides an emesis basin.
Mr. Dunner vomits into the emesis basin and then remains sitting on the side of the bed, stating he may need to “throw up” again.Which assessment should the nurse complete first?
A. Auscultate the bowel sounds.
Another assessment should be completed before assessing the client’s bowel sounds.
B. Palpate for abdominal distention.
Another assessment should be completed before assessing for distention.
C. Correct Observe the color of the emesis.
Since the client is vomiting, the nurse should first observe the color
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H. When does the client develop his intolerance to spicy foods.
Other information is more useful in assessing the client's inability to eat spicy foods.
After completing the client interview, where Calvin reports that he gets severe indigestion and heartburn after eating Mexican foods, the nurse is ready to begin the physical assessment of the abdomen.
5. The nurse prepares Calvin for the physical assessment of the abdomen. Before assisting him to a supine position, what action should the nurse take?
A. Correct Encourage the client to empty his bladder.
Emptying the bladder will help promote relaxation of the abdominal wall.
B. Ask the client to breathe deeply several times.
Breathing exercises may help relax the abdominal wall but should be done just prior to and during the examination, not prior to client positioning.
C. Darken the room lights and lower the thermostat.
A brightly lit room aids the nurse in accurate assessment. A chilled environment can increase muscle tension.
D. Instruct the client to place his hands over his head.
Placing the hands over the head can cause the abdominal muscles to tense.
After completing the preparations, the nurse assists Calvin to a supine position on the bed.
6. To assess the symmetry of the abdomen, what action should the nurse take?
E. Note pattern of hair growth.
The pattern of hair growth does not provide information related to the

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