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The medical reports of a patient indicate AAOX4. What does the nurse infer from the data in the report? 1 The patient is awake, alert, and oriented to all spheres. 2The patient is awake, alert, and oriented to two spheres, X 3 The patient is awake, alert, and disoriented to all spheres. The patient is awake, alert, and disoriented to one sphero. How does the nurse assess the elasticity of the skin in a patient thought to have dehydration? 2 By using a light palpation method anywhere on the body By inspecting edematous areas on the skin By inspecting reddened, pink, or pale areas on the skin X By folding the skin of the forearm with the fingertips and releasing The nurse is interacting with an elderly patient. Based on the patient’s behavior, the nurse suspects that the patient is suffering from delirium. Which statement by the patient helped the nurse to reach this conclusion? “My grandson is waiting for me in the day-care center.” “I just spoke to my great-grandfather on the phone.” “I am not happy with you and don’t like you.” “I am not happy with my life and want to end it soon.”
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