The nurse is caring for a 6-year-old patient in the emergency department who just
had a full left leg cast placed for a fracture. As the nurse is reviewing the discharge
instructions with the patient's mother, she states, "You don't have to go over those—
I'll read them at home." What should the nurse do?
a. Contact the physician immediately.
b. Consider the possibility of health literacy limitations and assess further.
c. Stop the teaching, because the mother obviously has taken care of casts before.
d. Explain to the mother that reading the instructions with her is required. - b.
Consider the possibility of health literacy limitations and assess further.
A patient's mother may have limited reading skills or health literacy and should be
further assessed. Contacting the physician in this situation would not be appropriate
because ensuring that the patient and family understand discharge instructions is
the responsibility of the nurse. Assuming that the mother has taken care of casts in
the past may be inaccurate. Stating that reading the instructions with the nurse is a
requirement does not ensure that the patient or mother comprehends the
instructions.
A 58-year-old man is admitted for a small-bowel obstruction late Saturday night. The
admitting orders include the need to place a nasogastric (NG) tube to low
intermittent suction. During the assessment, the nurse determines that the patient
does not speak English. Which action should the nurse take first before placing the
NG tube?
a. Use two additional staff members when placing the tube so the patient can be
restrained if needed.
b. Request an interpreter per facility protocol.
c. Do not place the NG tube because the physician would not want to frighten the
patient.
d. Document the inability to place the NG tube due to lack of ability to communicate.
- b. Request an interpreter per facility protocol.
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