A client diagnosed with pancreatitis is reporting severe epigastric pain and intense nausea.

After the nurse administers a narcotic analgesic and an antiemetic, the client insists on sitting up and leaning forward. Which action should the nurse implement?

Reinforce bed rest until analgesic is effective.

Place bed in reverse Trendelenburg position.

Raise head of bed until at a 90-degree angle.

Position bedside table for client to lean across.

Answer and Explanation

The Correct Answer is D

A.   Reinforcing bed rest until the analgesic is effective may not address the client's need to sit up and lean forward. It's important to respond to the client's discomfort and find a position that
provides relief.
B.   Placing the bed in reverse Trendelenburg position (head elevated, feet lowered) may not be the most effective position for a client experiencing severe epigastric pain and nausea. This
position could potentially worsen symptoms or discomfort.
C.   Raising the head of the bed to a 90-degree angle may not provide optimal relief for the client.
While it's essential to elevate the head of the bed for comfort and to prevent aspiration, it may not address the client's specific need to lean forward.
D.   Positioning a bedside table for the client to lean across allows the client to assume a position that often provides relief for epigastric pain associated with pancreatitis. Leaning forward can
help reduce pressure on the pancreas and alleviate discomfort. This position also facilitates drainage of gastric contents and may help alleviate nausea.

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Correct Answer is D

Explanation

A. Initiating teaching for client care after discharge is not within the scope of practice for a practical nurse (PN). Teaching, particularly initial or complex teaching, is a responsibility of the registered nurse (RN) because it requires assessment, planning, and evaluation of the client’s understanding.

B. Evaluating and updating plans of care is a responsibility of the RN. This activity requires critical thinking and clinical judgment to assess client progress and make adjustments to care plans, which are outside the PN’s scope of practice.

C. Performing the initial sterile wound care for surgical clients should be done by the RN. The initial wound care requires assessment of the wound’s condition, which is a task that involves critical thinking and is beyond the PN’s scope.

D. Validating prescribed intravenous flow rates is an appropriate task for the PN. This task is within their scope of practice as it involves verifying that the IV is running as prescribed but does not require the higher-level assessment and critical thinking skills reserved for the RN.

A. Liquid brown drainage from stoma. B. Stomal output of 40 mL in the last hour. C. Red edematous stomal appearance. D. Mucous strings floating in the drainage.

Correct Answer is A

Explanation

A. Liquid brown drainage from the stoma is abnormal and could indicate bowel content leakage, suggesting a potential connection between the bowel and the conduit or possible infection. This is a critical finding and should be reported immediately.

- B: A stomal output of 40 mL in the last hour is within normal limits postoperatively, as urine production can vary and this amount does not suggest acute complications.

C. A red and edematous stomal appearance is normal in the immediate postoperative period and indicates adequate blood supply to the stoma.

- D: Mucous strings in the drainage are normal because mucus is produced by the intestinal lining, which is now part of the urinary diversion. This is an expected finding and not a cause for immediate concern.

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A client diagnosed with pancreatitis is reporting severe epigastric pain and intense nausea. After the nurse administers a narcotic analgesic and an antiemetic, the client insists on sitting up and leaning forward. Which action should the nurse implement?

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A client diagnosed with pancreatitis is reporting severe epigastric pain and intense nausea. After the nurse administers a narcotic analgesic and an antiemetic, the client insists on sitting up and leaning forward. Which action should the nurse implement?

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A client diagnosed with pancreatitis is reporting severe epigastric pain and intense nausea.

After the nurse administers a narcotic analgesic and an antiemetic, the client insists on sitting up and leaning forward. Which action should the nurse implement?