A client is prescribed a cleansing enema. Prior to administering the enema, the client should be told to:
drink a full glass of water.
hold the solution for a couple of minutes.
take fast breaths through the nose.
lie on the left side with the right knee bent
The Correct Answer is D
D. Before administering a cleansing enema, the client is typically instructed to assume a left-side lying position with the right knee bent. This position helps to facilitate the flow of the enema solution into the colon and allows for better retention of the solution. It also helps to prevent leakage and discomfort during the procedure.
A. Drinking water before administering an enema can help hydrate the client and promote normal bowel function. However, it is not typically a specific instruction related to the administration of the enema itself. Hydration is generally beneficial for bowel health but is not directly related to the enema procedure.
B. After administering the enema solution, the client should be instructed to hold the solution in the bowel for a sufficient amount of time to allow it to soften and loosen stool. The exact duration can vary based on the type and purpose of the enema, but typically, the client is encouraged to retain the solution for a specified period (as instructed by the healthcare provider) before evacuating.
C. This instruction is unrelated to the administration of a cleansing enema. Breathing techniques may be taught for relaxation or to manage discomfort during procedures, but they do not specifically apply to the process of administering an enema.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
A. Bathing can indeed foster a nurse-client relationship. It provides an opportunity for interaction and communication between the nurse and the client, promoting trust and rapport.
B Bathing can contribute to the client's overall sense of well-being. It promotes comfort, relaxation, and a feeling of cleanliness, which are important aspects of holistic care.
C. Bathing allows the nurse to visually assess the client's skin integrity. During the process, the nurse can identify any changes in skin color, presence of lesions, wounds, or other abnormalities that may require further assessment or intervention.
D. Bathing, particularly when accompanied by gentle massage or movement of limbs, can stimulate circulation. This helps improve blood flow to tissues, aiding in wound healing and reducing the risk of complications such as pressure ulcers.
E. Depending on the type of bath products used (e.g., moisturizing soap or bath oils), bathing can help moisturize the skin. This is especially beneficial for clients with dry skin or conditions that predispose them to skin dryness.
Correct Answer is A
Explanation
A. This principle emphasizes the duty to do no harm. In the case of the client undergoing chemotherapy and experiencing severe side effects that significantly reduce their quality of life, the principle of nonmaleficence comes into question. Chemotherapy, while aimed at treating cancer, often causes substantial side effects that can impact a patient's well-being
BThis principle relates to fairness and equality in the distribution of resources, treatments, and outcomes. In the context of cancer treatment, justice could be considered in terms of ensuring equitable access to chemotherapy and supportive care, regardless of socioeconomic status or other factors.
C Fidelity refers to the duty to be faithful, keep promises, and maintain trust in the patient-nurse relationship. In this context, fidelity would involve the nurse advocating for the client's best interests, including addressing their concerns about the severe side effects of chemotherapy and their impact on quality of life.
D. Autonomy refers to respecting the right of the patient to make their own decisions about their care and treatment. In the context of cancer treatment, autonomy would involve ensuring that the client has sufficient information about their condition, prognosis, treatment options, and potential side effects to make informed decisions. However, autonomy may also be challenged when severe side effects significantly impact the client's ability to maintain their desired quality of life despite ongoing treatment.
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