A client who has cervical cancer is admitted to the hospital for placement of a cervical radiation implant. Which instructions should the nurse provide before insertion of the applicator?
Enemas and stool softeners are used during treatment.
Activity and ambulation as tolerated are encouraged.
Bed rest with minimal turning should be maintained.
A bedside commode will be provided for urination.
The Correct Answer is C
A. Enemas and stool softeners are used during treatment: While stool softeners may be used to avoid straining, enemas are generally not recommended just before the placement of the radiation implant due to potential disruption of the radiation site.
B. Activity and ambulation as tolerated are encouraged: During the placement of a cervical radiation implant, the client should remain on bed rest with minimal movement to avoid dislodging the implant. Ambulation is restricted during this procedure.
C. Bed rest with minimal turning should be maintained: The client should remain on bed rest with minimal turning to prevent displacement of the radiation implant. Movement could risk the implant becoming dislodged, so strict bed rest is required to ensure safety.
D. A bedside commode will be provided for urination: A bedside commode may be used to avoid unnecessary movement, but the priority is bed rest to prevent dislodging the implant. The nurse would provide guidance on minimizing movement, including using a commode as needed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Obtain a baseline complete blood count: While a complete blood count (CBC) may be important for some procedures, it is not a priority for amniocentesis unless there are signs of infection or complications.
B. Review maternal Rh factor status: Rh factor status is not the highest priority in preparation for an amniocentesis. The most immediate concern is ensuring that the client has access to intravenous (IV) access if necessary during the procedure.
C. Provide family support: While providing emotional support is important, the immediate priority is ensuring that the client is medically prepared for the amniocentesis, including having an IV line in place for possible medication administration or fluid needs.
D. Initiate a saline lock: The highest priority is ensuring that the client has a saline lock in place, as this provides access for medication administration or fluids, should complications arise. This ensures the client is medically prepared for any immediate needs during the amniocentesis.
Correct Answer is C
Explanation
A. A primiparous adolescent living at home with her parents and significant other: While being a young, first-time mother may pose challenges, the support system of living with parents and a significant other may help mitigate psychological risks.
B. A multiparous female with a large family living in the community: A woman with multiple children and a support system in the community is less likely to experience significant psychological difficulties, as she may be more experienced and have more resources to draw from.
C. A primiparous woman who has recently immigrated to the U.S. with her spouse: This woman is at high risk for psychological difficulties, such as postpartum depression, due to potential isolation, lack of support, cultural differences, and challenges adjusting to a new environment without an extended support network.
D. A multiparous client who lives with her husband and his family members: While living with extended family can sometimes present stress, this client has a support system, including both her husband and family members, which may help reduce the risk of psychological difficulties.
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