confused with this question, dunno which answer is right

[mc_gutierrez18]

if you suspect elder/child abuse what intervention should the nurse make?

1. report to proper authority

2. document findings

my review center told me to document findings while in the saunders book it says to report findings...i dunno which one is right, I'm confused.

[Nurseadam]

I have a question also:

A nurse is taking care of a client on contact isolation. After nursing care has been performed and upon leaving the room, the nurse removes protective items in which order of priority?

a)Unties the gown at the waist

b)Removes the gloves

c)Performs handwashing

d)Removes the mask and eyewear (goggles)

e)Discards the gown in appropriate receptacle

f)Unties the gown at the neck, allows it to fall forward toward the shoulders, and removes it.

Which order would you put this in??

I thought the order of taking PPE was Gloves, Goggles/Face shield, Gown, Mask/respirator...but apparently according to the answer to this, it's not.

What book are you using

[Kiwi82, BSN, RN]

This is from saund q&A

[Jolie, BSN]

Documentation is not a nursing intervention.

[reginakrys]

if you suspect elder/child abuse what intervention should the nurse make?

1. report to proper authority

2. document findings

my review center told me to document findings while in the saunders book it says to report findings...i dunno which one is right, I'm confused.

I think it depends on how the question is stated. If you are asked about the INITIAL intervention, I would guess it would be to document findings (considering there are no other more important choices like ensure patient safety, do physical assessment, etc). You need to have a written record of your observations before legal proceedings can take place.

If it asks what is the major legal responsibility in this situation, it would be to report. The children and elderly are incapable of protecting themselves, so they must be put under the protection of the proper agencies. I encountered this question during my review, and our instructor reasoned that documentation is done after pretty much everything, but reporting to authorities is SPECIFIC to this situation.

[Kiwi82, BSN, RN]

Documentation is not a nursing intervention.

So you never write anything in the patient's file??

[PrinceofSiamRN]

it is a nsg intervention.. yet in this case not the priority nsg intervention

[Jolie, BSN]

So you never write anything in the patient's file??

Of course you document, but documentation is not a nursing intervention. It is record keeping. Nursing interventions are the actions taken to render care, education, guidance, etc. to the patient/family/community.

In this example, contacting social services (or whatever the process for reporting suspected abuse) is the intervention.

For what it's worth, assessment is not a nursing intervention, either. It is data collection.

Unfortunately, many nursing programs fail to make these distinctions to students, causing them confusion on questions such as these.

[Kiwi82, BSN, RN]

I know you document...but saying that it is NOT a nursing intervention...was well...lets just say questionable.

[Kiwi82, BSN, RN]

Documenting the findings are writing in the patients file...that bla bla that you write every shift. It IS a nursing intervention. RN's HAVE TO document their findings (call is charting or whatever)

[Jolie, BSN]

I know you document...but saying that it is NOT a nursing intervention...was well...lets just say questionable.

Kiwi82,

I believe you are confusing nursing interventions with the nursing process as a whole. Interventions are one part of the overall process.

Depending upon your nursing education, the terms may vary a bit, but in general, the nursing process has the following steps:

Assessment: (Collection and evaluation of subjective and objective data)

Planning of nursing care

Implementation of nursing care plan: (These are nursing interventions, the actions you take on behalf of your client)

Evaluation

Documentation

So documentation is an essential component of the nursing process, but it is not a nursing intervention. This is a common mis-understanding students have, and it leads to unnecessary confusion on NCLEX-type questions when they are unable to distinguish between nursing interventions and other steps in the nursing process.