Sue is a nursing student. She is

Sue is a nursing student. She is to care for Mr. Nelson, a 63-year-old client who was admitted to the hospital with heart failure and pneumonia. He is receiving medications to improve his heart failure and intravenous antibiotics to treat his pneumonia. He reports becoming fatigued easily during care activities and states, “I feel short of breath if I try to do too much.” Sue notes he has 3+ edema in his lower extremities. Sue has identified nursing diagnoses of decreased cardiac output and activity intolerance. Sue must still perform hygiene measures, change the client’s intravenous dressing, get him up into a chair, and measure noontime vital signs. a. Before she begins to intervene, how can Sue make Mr. Nelson more comfortable? b. What objective data does Sue obtain as part of her nursing assessment? What nursing actions may be implemented on the basis of this information? c. Because Sue thinks that Mr. Nelson may be at risk of falling, she decides to get assistance from a colleague before trying to get him into a chair. This is an example of what type of implementation skill? d. When changing Mr. Nelson’s intravenous dressing, Sue cleans the insertion site in accordance with clinical practice guidelines and checks the site for signs of phlebitis. These steps are examples of what type of direct care measure?

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