A client with bladder cancer had surgical placement of a ureteroileostomy (ileal conduit) yesterday. Which postoperative assessment finding should the nurse report to the healthcare provider immediately?

A. Encourage three large meals a day. This may not be appropriate for the client's current dietary plan, especially after bariatric clinic involvement and dietitian consultations.
B. Start with room temperature water. While hydration is important, this advice is too vague and does not consider the client's specific nutritional needs or restrictions.
C. Anticipate weight loss will continue even with normal diet. Weight loss should be monitored and managed carefully, especially after bariatric treatment; it should not be assumed to continue without ongoing effort and adherence to a dietary plan.
D. Walk frequently during recovery. Encourage the client to continue with regular, gentle walks as tolerated to promote circulation and weight management, which is consistent with the client's recent weight loss through walking.
E. Expect immediate return of ovulation. There is no information provided that correlates the client's medical condition with ovulation status.
F. Begin taking supplements per the healthcare provider's orders. If the healthcare provider has recommended supplements, ensure the client understands the importance of taking them as directed to support overall health.
G. Advance diet from clear liquids to full liquid. As the client recovers, it's important to gradually reintroduce different types of food, starting with clear liquids and moving to full liquids as tolerated before progressing to solid foods.
H. Dietician appointments are optional. Given the client's history with weight management and engagement with a bariatric clinic, continued dietitian support is likely crucial for sustained success.

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.