A client has just been admitted to the Post Anesthesia Care Unit after electroconvulsive therapy (ECT). Which intervention will the nurse perform first?
Orient the client and offer reassurance
Encourage the client to drink some fluids
Orient the client and monitor vital signs
Assist the client from the stretcher to a wheelchair
The Correct Answer is C
C. After ECT, the client may be disoriented, confused, or drowsy due to the effects of anesthesia and the procedure itself. Orienting the client to their surroundings and situation helps promote their safety and comfort. Monitoring vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, is crucial to assess the client's immediate post-procedural status and detect any complications.
A. Offering reassurance can help alleviate any anxiety or confusion the client may experience. However, while this intervention is important, it may not be the first priority immediately upon admission to the Post Anesthesia Care Unit (PACU).
B. Hydration is important after any medical procedure, including ECT. However, immediately after ECT, the client may still be recovering from anesthesia and may not be fully alert or able to safely drink fluids.
D. Assisting the client with mobility is important but it may not be the first intervention performed in the PACU after ECT. The priority immediately upon admission to the PACU is to ensure the client's safety.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. Individuals with BPD often experience intense fears of abandonment and may go to great lengths to avoid being alone. They may also have difficulties being alone due to chronic feelings of emptiness and the need for others to help manage emotions. This characteristic is consistent with the known symptoms of BPD, which include efforts to avoid real or perceived abandonment and a pattern of intense and unstable relationships.
A. Individuals with borderline personality disorder (BPD) often struggle with regulating their emotions, including anger. While they may experience intense emotions such as anger, they typically have difficulty controlling or expressing it in a healthy and adaptive manner.
B. Stable and satisfactory relationships: Stability in relationships is often a challenge for individuals with BPD. They may experience intense and unstable interpersonal relationships characterized by idealization and devaluation of others.
D. Predictability is generally lacking in individuals with BPD due to their emotional instability, impulsivity, and difficulty regulating their behaviors and responses to situations.
Correct Answer is B
Explanation
B. It's essential for the client to receive accurate information about their safety, efficacy, and potential interactions with other medications. Health food store employees may not always have the necessary expertise to provide comprehensive information on these aspects.
A. Yoga can indeed improve flexibility and balance, which can be beneficial for individuals with osteoarthritis. Therefore, this choice does not indicate a need for client teaching.
C. Glucosamine helps with pain control and bone remodeling to improve overall functionality.
D. Prayer and spirituality can provide emotional support and improve overall well-being, they may not directly address the underlying physical symptoms of osteoarthritis. This may indicate a need for client teaching, as it may reflect the client's personal beliefs and coping strategies.
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