5.4.1: FRAME 1- Recognize Cues

CORRECT Answer

Question Type: Drop-Down Cloze

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The telemetry nurse reviews their notes taken from the phone report and reviews the client’s history. Choose the most likely options for the information missing from the statement(s) by selecting from the list of options provided.

The nurse recognizes the client’s impact healthcare approaches. The nurse will closely monitor the client’s , , and cues while on the telemetry floor and in preparation for discharge.

Dropdown 1 options	Dropdown 2 options	Dropdown 3 options	Dropdown 4 options
Recent surgery	Hemoglobin	JP drain	Pulses
Cultural and religious beliefs	Oxygenation	Midsternal incision	Alcohol withdrawal
Social determinants of health	Heart rate	Mental capacity	Left leg incision
Medical history	Blood pressure	Lab values	Motivation

RATIONALE

Relevant cues include the client’s clinical presentation including diminished breath sounds, lower pulse oximetry reading, weakness, hemoglobin, and red blood cell values. These clinical presentation cues indicate to the nurse how well oxygen is being transported around the body and to the cells. The client’s occupation may affect her ability to return to work after her surgery due to physical stressors and lifestyle modifications that will need to be made. Additionally, the client’s flat affect, low spirits, and history of depression are relevant to the client’s current situation and condition because of the high risk of postoperative depression and the client showing signs of a slower recovery. Feelings of hopelessness and adjustments to an individual’s lifestyle after a major surgery are relevant in post-operative cares.

The nurse must recognize and analyze cues from client’s that allow them to provide holistic care approaches. Utilizing therapeutic and empathetic communication styles allows the nurse to effectively communicate and listen to their clients to advocate the needs and wishes of clients. Nursing empathy is characterized by the nurses’ ability to understand the feelings, experiences, or psychosocial ability of their client(s) (Wu, 2021). Empathy plays an important role in establishing a positive nurse-client relationship, resulting in favorable nursing care.

FOCUSED GUIDE

Cultural and religious beliefs, such as Jehovah’s Witnesses who do not accept blood or primary blood components are particularly important for healthcare providers to consider as it can present an array of social, legal, and ethical challenges, especially in major surgeries at risk for bleeding and blood loss. In the past, Jehovah witnesses were often not considered for major surgeries such as cardiac surgery due to the increased risk of morbidity and mortality. However, as research has evolved, there have been improvements made in blood management strategies, technology advances, surgical procedure, and approaches (Chambault et al., 2020).

This case study focuses on cultural/religious beliefs and mental stability of clients undergoing major surgery and addresses two of the five social determinants of health: health care access and quality, and social and community context. Access to preventative health care can prevent both disease and early death. This client has not been to a healthcare provider in over seven years. Multiple factors can play into this reasoning, and it is important for students to recognize there are disparities. Millions of people in the United States do not get the recommended preventive health care services related to screenings, dental check-ups, and vaccinations. Barriers to this include a variety of reasons such as cost, not having a primary care provider, distance from provider, and lack of awareness or health literacy about recommended preventative services (U.S. Department of Health and Human Services, n.d.). It is estimated that 80% of cardiovascular disease is preventable, however it remains the number 1 killer and most expensive disease costly nearly one billion dollars a day. Recent projections show that by 2035, 45% of the adult population in the United States will live with cardiovascular disease (American Heart Association, 2022).

Enhance the student’s awareness of implicit bias and describe that implicit bias is unconscious mental associations individuals make about various social groups that can impact understanding and actions. Unintentional bias contributes to health disparities through its effect on communication patterns between clients and healthcare providers and clinical /medical decisions further impacting client care (Rodriguez et al., 2021). It is important for nurses to recognize all individuals have implicit biases and awareness is essential towards actions taken.