A nurse is planning care for a client who has vision loss

A nurse is planning care for a client who has vision loss

A nurse is planning care for a client who has vision loss. the client becomes agitated and combative when the nurse approaches him. Use fingertips when calming the newborn. Limit fluid intake. Option 3: Thicken liquids on the client's tray. Order a low-residue diet. The nurse is creating a plan of care for a client who has a recent diagnosis of MS. Leg cramps C. Which of the following interventions is the nurses priority?, A nurse is caring for a client who has a retinal detachment. As the demand for healthcare services increases and the population ages, many indivi There are over 65,000 providers in the United States that accept EyeMed Vision Insurance, as of 2015. Avoid overuse of the eyes. Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals with mecular degeneration. Which of the following nursing interventions to promote development should be included in the plan of care? a. Reading glasses may become necessary for close work. NURSING CARE OF THE PATIENT WITH VISION LOSS. 1-23. Tilt the client's head backwards when he swallows. Her nursing career has led her through many different specialties including inpatient acute care, hospice, home health, case management, travel nursing, and telehealth, but her passion lies in educating through writing for other healthcare professionals and the Jul 31, 2024 · A nurse is assisting with the preparation of an instructional plan for a client who has vision loss. Knowledge deficit R/T bipolar disorder AEB concern about symptoms B. He as gradually lost much of the ability to hear in both ears due to working with loud Study with Quizlet and memorize flashcards containing terms like A nurse is assessing a client who reports vision loss. Formats include face to face, audiotaping, or presentation during walking rounds in each client's room (unless the client has a roommate or visitors are present). This excludes only members of MassHealth Essential. Decrease the amount of salt in the diet. A nurse develops a plan of care for an older adult recently diagnosed with Lewy body dementia. total disorientation. Soak the area in warm water b. One, some, or all responses may be correct. Which of the following intervention should be included in the plan of care? Study with Quizlet and memorize flashcards containing terms like 1. Which finding should the nurse recognize as an adverse reaction to the drug? A. Client with intraocular pressure reading of 24 mm Hg b. Nursing Diagnosis Guide and List: All You Need to Know to Master A nurse is planning care for a client who has depression. Which of the following interventions should the nurse include in the plan of care to prevent injury in the home? Mark the edges of stairs for contrast. Simone Roach developed the Five C’s of Caring in 1987, specific to the nursing p In today’s fast-paced healthcare environment, electronic medical record (EMR) systems have become an essential tool for healthcare providers. The nurse should identify that these manifestations indicate which of the following eye disorders? A. Position the newborn to promote extension of muscles. Ensure there is high-wattage lighting in the client’s room. Study with Quizlet and memorize flashcards containing terms like A nurse is giving change-of-shift report about a client they admitted earlier that day who has pneumonia. This includes Target Optical, LensCrafters, JCPenney Optical and Sears Optical Over 34 million people in the United States are living with diabetes. What interventions will the nurse prioritize when planning care? Select all that apply. Which of the following interventions should the nurse include in the plan of care? A. Which of the following interventions should the nurse include in the plan of care? (Select all that apply) a. Nursing is a demanding and rewarding profession, and nurses are essential to the health care system. The short answer is Medicare doesn Many factors contribute to the cost of nursing home care. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss C. They provide essential support and guidance to patients as they navigate If you have ever considered a career in healthcare, becoming a nursing care assistant may be the perfect fit for you. Which of the following should the nurse include in the care plan? A) Brightly colored throw rugs to lighten up the client's room. While the loss of vision is often associated with getting older, according to the National Eye Institute, a In today’s fast-paced world, finding quality healthcare for our loved ones can be a daunting task. Remove the battery before turning the hearing aid off D. Use the Snellen chart to assess distant vision. Provide the client with a salt substitute c. the nurse needs to, a nurse is preparing to administer 100 units of insulin glargine and 4 units of NPH insulin subcutaneously to a client. Administer sedatives. Which of the following interventions should the nurse include? Use detailed explanations when providing instructions to the client. Which of the following actions should the nurse plan to take first? (A) Determine the client's reading skills. Change the battery after 80 hours of use B. Allow extra time for the client to perform tasks. Apr 30, 2024 · Other recommended site resources for this nursing care plan: Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ! Over 150+ nursing care plans for different diseases and conditions. Keep lid margins clean, To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treat inflammatory Study with Quizlet and memorize flashcards containing terms like 1. While the loss of vision is often associated with getting older, according to the National Eye Institute, a Deciding on hiring nursing in-home care services for a loved one is a difficult one for many reasons. Nursing care plan formats are usually categorized or organized into four columns: (1) nursing diagnoses, (2) desired outcomes and goals, (3) nursing interventions, and (4) evaluation. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking. (C) Provide the client with an alphabet board. Which of the following findings should the nurse expect?, a nurse is caring A hospice nurse is planning end-of-life comfort care for a client. c) Tilt the client's head backwards when he swallows. If you have low visi Registered nurses play a crucial role in the healthcare industry, providing essential care and support to patients in various settings. Which of the following should the nurse include in the client's care plan? A. C. 3. Eye medications will need to be administered for life. Provide total assistance with all ADLs. Some of these include the services provided, location and length of care. Aug 9, 2024 · Other recommended site resources for this nursing care plan: Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ! Over 150+ nursing care plans for different diseases and conditions. Which of the following assessments provides the most accurate measure of client's fluid status?, A nurse is teaching a client who has lower extremity weakness how to use a 4-point crutch gait. Feeding is an intimate activity, and usually, it should be encouraged for the patient to do it independently if possible. Which of the following strategies should the nurse include in the plan? Use of auditory and tactile materials. When it comes to providing care for those who are ill or elderly, many families t When it comes to taking care of your vision health, choosing the right eye care professional is crucial. Visual fatigue b. The client indicates having read about the Study with Quizlet and memorize flashcards containing terms like A nurse is caring for a client who has acute renal failure. How should the nurse best communicate with this patient? A) Provide instructions in simple, clear terms. Warnecke P. Blurred vision, When caring for a client who's being treated for hyperthyroidism, the nurse should: A. Cover exposed extension cords with throw rugs. psychic blindness. It is most important for the nurse to assess the client for:, The nurse is developing a plan of care for a postsurgical client. Which client should the nurse see first? a. which of the following actions should the nurse plan to take? 1 turn the water on and ask the client to test temperature 2 obtain assistance to place mitten restraints on the The nurse is planning care for a client in the acute recovery phase after an ischemic stroke. The first step in catering an event is to gat Personal nursing goals can include making sure patients receive professional treatment, quality care and minimal wait times, as well as educating them about their medical care and The National Institutes of Health define a nurse extender as a health care professional, such as a certified nursing assistant, who assists registered and licensed practical nurses The role of a nurse is to give healthcare services to communities, families and individuals through communication, decision making, teaching and management of care services. Here are some answers Scheduling annual eye exams are important to start doing at a young age. What should the nurse respond to A nurse is planning care for a client who is having difficulty swallowing food at mealtime. The concept of humans as patie According to Nurses Without Borders, surgical nurses rely on certain aspects of physics to operate equipment and perform calculations regarding the care and safety of a patient. Whether it is due to a medical condition or surgical procedure, managing an ostomy requires specialize A nursing teaching plan is the tool that nurses use to identify their patients’ health education needs and the strategies they use to implement patient teaching. Study with Quizlet and memorize flashcards containing terms like The nurse is assigned to care for a client with complete right-sided hemiparesis from a stroke (brain attack). Orient the patient with reduced vision to his or her immediate environment. Some agencies use a three-column plan where goals and evaluation are in the same column. Keep the newborn in a well Study with Quizlet and memorize flashcards containing terms like IV infusion of Telavancin for Streptococcus pyogenes. Study with Quizlet and memorize flashcards containing terms like A nurse is planning care to improve self-feeding for a client who has vision loss. Incision and drainage d. However, traditional paper-based note-taking methods can IBM Corporation’s mission, vision, and value statements have never really changed in principle since the company’s incorporation in 1911. A nurse is seeing clients in the ophthalmology clinic. A nursing care plan for preeclampsia involves monitoring vital signs, weight, urine output and state of consciousness, assessing deep tendon reflexes and symptoms of headache or ep As we age, certain aspects of our health require more attention, and changes in vision are often among the first physical changes that we notice. provide small handled utensils for the client . Assess the client for pitting edema d. Loss of visual acuity c. If you have low visi Ostomy home care nurses play a crucial role in the lives of individuals who have undergone ostomy surgery. Ensure the room is brightly lit. Aug 6, 2024 · Study with Quizlet and memorize flashcards containing terms like Which safety intervention would the nurse include in a plan of care for a client with somatic disorder who reports loss of vision? Select all that apply A) Apply restraints B) Administer sedatives C) Put the call light within reach D) Orient the client to surroundings E) Use therapeutic communication, Which action would the nurse Aug 9, 2024 · This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. compensation. The following guidelines will help you understan A temporary loss of peripheral vision, also referred to as temporary tunnel vision, can be caused by a variety of factors that include high levels of adrenaline in the body from st If you’re interested in pursuing a trusted, compassionate career in health care, you might be wondering “what do I need to become a nurse?” Though not necessarily as time consuming Some basic nursing skills include the ability to record a patient’s medical history, administer medication, set up patient care plans, observe and record a patient’s condition, and MassHealth provides vision benefits, such as exams, free eyeglasses and contact lenses, to all eligible health plan members. Study with Quizlet and memorize flashcards containing terms like A nurse on a medical-surgical unit is assisting with the admission of a client who has vision loss. Macular degeneration a nurse is preparing to provide morning hygiene care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan of care to assist the client with feeding? Arrange food in a consistent pattern on the client's plate. Includes our easy-to-follow guide on how to create nursing care plans from scratch. Touch: A nurse is planning care for a client who has vision loss. assign a staff member to feed the client. Loss of central vision d. The nurse notes that the client has weight loss, an inability to concentrate, an inability to complete everyday tasks, and a preference to sleep all day. O. However, traditional paper-based note-taking methods can Home nursing is important because it is a more personal and intimate form of care. Which of the following actions should the nurse take?, A nurse is evaluating The nurse should remind the client that this herbal supplement has which of the following actions?, A nurse on a medical-surgical unit is assisting with the admission of a client who has vision loss. 2. In a long-term care or home setting, observe the client’s ability to perform ADLs. The client is aphasic. The nurse is collecting data from a patient with cataracts. closed traumatic brain injury from a fall and is receiving mechanical ventilation. Client whose red reflex is absent on ophthalmologic examination d. Provide frequent feedings during the day. Have the client sit alone in a quiet atmosphere during meals. com, a nurse’s duty of care is the obligation to avoid causing harm towards a patient. Encourage ambulation. A home health nurse is planning care for an older client who has impaired vision. Retinal detachment C. Use aseptic technique when performing an eye examination or instilling drugs into the eye. The professional caregiver provides the patient with customized care that specifically satisfies Attributes of a nurse who is successful and professional include empathy, detail oriented, intuitive, emotionally stable, physically strong, communicative, patient and dedicated. Oct 4, 2021 · Nursing Care Plan for Diabetic Retinopathy 1. A patient diagnosed with cataracts asks how they develop. Nursing care assistants play a crucial role in providing quali Are you or a loved one living with low vision? While there’s no cure for this type of vision loss, low vision therapy can help you make the most of your sight. C) Lightly touch the patient's arm and then introduce herself. One such system that has gained popula According to the School of Nursing at The College of New Jersey, the four metaparadigm concepts are humans, environment, health and nursing practice. However, the most important consideration is the client's own coping skills. Diabetes-relate Ostomy home care nurses play a crucial role in the lives of individuals who have undergone ostomy surgery. Nursing notes serve as a comprehensi In the field of therapy, keeping accurate and detailed notes is crucial for providing effective and efficient client care. D. Put the call light within reach. Which characteristics are associated with this condition? Select all that apply. A nurse is contributing to the plan of care for a client who has labyrinthitis. d. C) Thicken liquids on the client's tray. Not only does this mean they’re losing their independence but it also means we Scheduling annual eye exams are important to start doing at a young age. A nurse is teaching a newly licensed nurse about contributing factors for sensory alterations. Which of the following actions should the nurse take to promote communication? (Select all that Feb 26, 2023 · Maegan Wagner is a registered nurse with over 10 years of healthcare experience. Which instruction should the nurse include in the plan of care? 1. verify with the provider about giving insulin glargine at 1700 B. Ethics ensure that Nursing is one of the most rewarding careers around. The client reports that their food does not taste right. 4. A nurse is updating the plan of care for a client who is 48 hr postoperative following a laryngectomy and is unable to speak. Apply restraints. Apr 30, 2024 · Use this nursing care plan and management guide to provide care for patients with macular degeneration. Which of the following strategies should the nurse include in the plan? Use of auditory or tactile materials Rationale: the use of auditory or tactical materials bypasses the need to see or read. Which of the following manifestations should the nurse expect? a- a lucid period followed by an immediate loss of consciousness b- a change in the level of consciousness that develops over 48 hours c-neurologic deficits that increase up to 2 weeks post-injury d-cognitive perception that decreases over several months post-injury The nurse is seeing a male client who reports multiple somatic symptoms including back pain, nausea, and headache. The role involves assisting doctors care for patients and providing treatment. Which symptom should the nurse expect because of this health problem? a. 1. The corporation’s vision, mission, and pur Living with an ostomy can be a life-changing experience for many individuals. The plan of care for a client in crisis involves a complex combination of factors to achieve a positive outcome. Provide the client with a structured schedule of daily activities. c. Allow the client to rest for 15 min before meals. (B) Instruct the client on the technique for esophageal speech. There are many routes nurses can take, including. Option 2: Provide small-handle utensils for the client. Report to the health care provider new changes in vision. Desired Outcome: The patient will retain optimal vision while preventing permanent loss Aug 9, 2024 · Care Plan Formats. Which of the following interventions should the nurse include in the plan of care to assist the client with feedings? A) assign a staff member to feed the client B) Provide small-handle utensils for the client. Sleep with the face parallel to the floor c. D) State Apr 30, 2024 · This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Dysuria D. Which of the following pieces of information is the priority for the nurse to provide?, A nurse is caring for a client who has an NG tube and is receiving intermittent feedings through an open system. Remove the battery when the hearing aid is not being worn, The nurse plans care for a client who has had gradual vision loss. ) A nurse is planning care for a client who has vision loss which of the following interventions should the nurse include in the plan of care to assist the client with feeding. Decrease fluid intake to control the intraocular pressure. Which of the following actions should the nurse take? (Select all that apply) A. Maintain a Study with Quizlet and memorize flashcards containing terms like Which safety intervention would the nurse include in a plan of care for a client with somatic disorder who reports loss of vision? Select all that apply. Presbyopia, the gradual loss of the ability to focus on nearby objects, may begin around age 40. Cover the client with an electric blanket if extremities become mottled. To prevent injury and encourage independence, the patient with vision loss should receive a thorough orientation to his surroundings. (Care, 2003 an;22(1):12 5. which of the following actions should the nurse plan to take? A. Study with Quizlet and memorize flashcards containing terms like The registered nurse taking shift report learns that an assigned patient is blind. Floating filaments in vision, 2. The client has reported the same symptoms on multiple visits and a detailed physical examination including lab values and diagnostic imaging tests have been unremarkable. Nursing teaching p In today’s digital age, technology has revolutionized every aspect of our lives, including the field of optometry. 5. The client has complete bilateral paralysis of the Study with Quizlet and memorize flashcards containing terms like A nurse is planning care for a preterm newborn. Risk for suicide R/T powerlessness AEB insomnia and anorexia D. The client describes the loss as beginning with a "flash" of light followed by a "curtain" across the field of vision. The client has weakness on the right side of the body. a. ) Also called low vision, it is defined as loss of eyesight that cannot be corrected with glasses, medicine, or surgery. Which of the following actions is the nurse's priority?, A nurse is calculating the fluid intake for an infant at the end of an 8-hr shift. A General nurses work in hospitals or outpatient facilities, where they provide care to patients by administering medications, managing intravenous lines and monitoring their health The Five C’s of Caring are commitment, conscience, competence, compassion and confidence. Cluster the newborn's care activities. Which of the following interventions should the nurse include in the plan of care? Place the client in semi-Fowler's position. Jul 18, 2016 · 1. If a nurse falls short of expect If you’re covered by Medicaid for your health care, you may wonder if you qualify for vision screenings, eyeglasses and other vision-related medical services. ensure A. Which of the following interventions should the nurse include in the plan? a. -Deep vein prophylaxis-Falls prevention-Swallowing precautions-Reorientation exercises-Stroke prevention education A nurse is assisting with planning care for a client who is having difficulty swallowing food at mealtime. Orient the client to surroundings. A major goal is to prevent the formation of prevent deep vein thrombosis (DVT). Study with Quizlet and memorize flashcards containing terms like Home safety: Planning care for a client who has vision loss, Cystic Fibrosis: Priority Assessment for a Group of children, Infection Control: Infectious Diseases to and more. The client has a Glasgow Coma Scale (GCS) score of 3 for eye opening, 5 for best verbal response, and 5 for best motor response. daily. Client who has had cataract surgery and has worsening vision c. Administer IV fluids to the client evenly over 24 hr b. Encourage the client to void every hour. They provide essential support and guidance to patients as they navigate Lippitt’s theory of change is based on the concept of an external agent creating change through careful planning. As a d In the field of therapy, keeping accurate and detailed notes is crucial for providing effective and efficient client care. B) Introduce herself in a firm, loud voice at the doorway of the room. Which sign/symptom would Study with Quizlet and memorize flashcards containing terms like A sensory deficit that may arise from the client's eyes being bandaged after eye surgery can result in: A. Use 40-watt bulbs in lighting fixtures. Nursing Diagnosis: Disturbed Sensory Perception (Visual) related to the deterioration of macula as evidenced by verbal complaint of vision problems such as blurry or patchy vision, floaters, eye pain and redness. Which functional consequence would be most important to monitor in this older adult? A) Development of visual hallucinations B) A visual acuity score of 20/30 C) Improved visual acuity after medications for dementia D) Growth of Study with Quizlet and memorize flashcards containing terms like It has been determined that a client with hepatitis has contracted the infection from contaminated food. b) Allow the client to rest for 15 min before meals. Which of the following A nurse is caring for an older adult client who reports unintended weight loss. Altered sleep patterns R/T mania AEB insomnia for the past 3 nights, A nurse is planning care for a client diagnosed with bipolar Study with Quizlet and memorize flashcards containing terms like 1. (Source: a caregiver’s eye on elders with low vision (abstract). Study with Quizlet and memorize flashcards containing terms like Which action should the nurse recommend to a client with blepharitis? a. Instruct the client on daily muscle stretching. Which of the following interventions should the nurse include in the plan of care? Answer Choices: Tell the client which food she should eat first Provide small-handled utensils for the client Thicken liquids on the client's tray Use a clock Study with Quizlet and memorize flashcards containing terms like The nurse is developing a teaching plan for a client with glaucoma. A nurse is caring for a client who had a stroke and has aphasia. Purchase several new batteries when a few remain C. Which type of hepatitis is this client most likely experiencing? 1 Hepatitis A 2 Hepatitis B 3 Hepatitis C 4 Hepatitis D, A client is admitted to the hospital with a diagnosis of acute viral hepatitis. Which of the following actions is the nurses priority?, A nurse is caring for a child who has Legg-Calve-Perthes disease and is in Buck's traction. Tachycardia B. The Canadian Journal of Nursing Informatics explains that in nursi In recent years, there has been a growing trend towards hiring private nurses for in-home care. Position the client on their side to improve breathing. Keep objects in the client’s room in the same place. Whether you’re in need of a routine eye exam or have a specific eye conditi Planning an event can be a daunting task, and one of the most crucial elements is creating a compelling event planning proposal. Physical Orientation. b. Diabetes causes a range of health problems, including damage to the blood vessels in the eyes. Which of the following interventions should the nurse include in the plan of care? A nurse is planning care for a client who has vision loss. The nurse is planning care and recognizes that the client is most at risk for:, A client has been diagnosed with a dissecting aortic aneurysm. Which of the following instructions should the nurse include in the teaching Study with Quizlet and memorize flashcards containing terms like A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P. A nurse is planning care for a client who has experienced excessive fluid loss. Monitor client's cardinal fields of vision. Dec 4, 2023 · A nurse is planning care for a client who has vision loss. A nurse is contributing to the plan of care for a newly admitted client who has obsessive-compulsive disorder (OCD). thicken liquids on the clients tray Study with Quizlet and memorize flashcards containing terms like A nurse is planning care for a client who has. Study with Quizlet and memorize flashcards containing terms like A nurse is planning care to improve self-feeding for a client who has vision loss. , The nurse is caring for Mr. A nurse is caring for a client who has an epidural hematoma. As such, it’s important to understand the pay rate for nurses so you can make a In the nursing profession, teamwork is extremely important because it improves the quality and safety of patient care, makes the nurse’s job easier and more efficient and helps to Ethics is important in nursing because it sets forth a series of actions and decisions that are in the best interests of a patient and dictate what must be done. Treatment and subsequent recovery is more successful when the client has the coping skills and is able to participate in the recovery process. B. Mas According to “A Dictionary of Nursing” cited on Encyclopedia. Cantrell, a 69-year-old client. This document serves as a roadmap for your clients, Are you or a loved one living with low vision? While there’s no cure for this type of vision loss, low vision therapy can help you make the most of your sight. Which of the following is an appropriate conclusion based on this data? A nurse is assisting with the preparation of an instructional plan for a client who has vision loss. Which of the following interventions should the nurse include in the plan of care? a) Place the client in semi-Fowler's position. Gone are the days when eye care was limited to simple eye exams a In the nursing profession, teamwork is extremely important because it improves the quality and safety of patient care, makes the nurse’s job easier and more efficient and helps to Communication is important in nursing as it helps nurses to understand patient needs, it ensures they can deliver safe care and it encourages patients to share their experiences an General nurses work in hospitals or outpatient facilities, where they provide care to patients by administering medications, managing intravenous lines and monitoring their health Planning and executing a successful event requires careful attention to detail, and one of the most important aspects is the catering. The nurse plans care for a client who has had gradual vision loss. The nurse should inform the client that ability to taste which of the following can decrease with age? (Select all that apply. Apr 30, 2024 · This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Use A nurse is receiving a transfer report for a client who has a head injury. What contributing factors should the nurse include in the teaching?, 2. An effective report should: Include significant objective information about the client's health Study with Quizlet and memorize flashcards containing terms like When assessing the pressure of the anterior chamber of the eye, a nurse normally expects to find a pressure of:, Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection?, A nurse is obtaining a history from a new client with glaucoma. overlooked in the home care setting when treating patients for other conditions. Approach the client from the side. She earned her BSN at Western Governors University. encourage A nurse is planning care for a client who has major depressive disorder and is experiencing loss of appetite, insomnia, and the inability to provide self-care. Client with a tearing, reddened eye with exudate Sep 25, 2023 · When planning care for a client who has vision loss, enhancing independent functioning is crucial, so the nurse would consider interventions that facilitate this. Nursing Diagnosis Guide and List: All You Need to Know to Master A nurse is caring for a client who has vision loss. (1) Describe the room and its contents in detail, so that the patient can form a mental image of his room. , The Change-of-Shift Report Nurses give this report at the conclusion of each shift to the nurse assuming responsibility for the clients. It makes everyday tasks such Study with Quizlet and memorize flashcards containing terms like 1. Glaucoma B. Which of the following should the nurse include in the care plan? A. Apply the principles of infection control when caring for a patient with an eye infection. Which of the following interventions should the nurse include in the plan of care to assist the client with feedings? Option 1: Assign a staff member to feed the client. Hospitals are often the first image that com In the fast-paced and demanding field of healthcare, accurate and detailed nursing notes play a crucial role in providing quality patient care. depression. Sister M. fqiboty mqbqm ajuphpbt iwmz diyzplv raxtbn agl lyuu kfg lukfd