A client with psoriasis reports an increase in symptoms. Which action should the practical nurse (PN) implement?

Choice A reason: Maintaining the client in a recumbent position is not typically necessary on the first postoperative day following an appendectomy. While it is important to ensure the client is comfortable and to monitor for signs of complications, encouraging mobility as soon as it is safe is generally beneficial. Prolonged bed rest can lead to complications such as deep vein thrombosis (DVT) and respiratory issues. Therefore, this intervention is not the most appropriate for promoting recovery and ensuring the client's well-being.
Choice B reason: Applying moist heat for pain relief is generally not recommended in the immediate postoperative period following an appendectomy. The use of heat can increase blood flow to the surgical site and potentially exacerbate inflammation or swelling. Pain management should be approached with appropriate analgesics as prescribed by the healthcare provider. Additionally, it is crucial to monitor for signs of complications such as infection or hematoma, and moist heat may not be the safest method for addressing postoperative pain in this context.
Choice C reason: Restricting ambulation to the bathroom only may be overly restrictive and can hinder the client's recovery process. Encouraging early and safe ambulation is important to prevent complications like DVT, promote circulation, and support overall recovery. While it is essential to ensure that the client does not overexert themselves, completely restricting movement to only bathroom trips is not conducive to optimal postoperative care. Gradual, supervised ambulation should be encouraged as the client's condition permits.
Choice D reason: Documenting the first bowel movement is a crucial intervention following an appendectomy. It provides important information about the return of gastrointestinal function, which can be affected by both the surgery and anesthesia. Monitoring and recording bowel movements help ensure that the client is not experiencing postoperative ileus, a common complication characterized by a temporary cessation of bowel activity. Early detection of such issues allows for timely intervention and supports the client's overall recovery.

Choice A reason: This response provides the client with reassurance about hair regrowth after chemotherapy. It acknowledges that while hair loss due to chemotherapy is a common side effect, it is usually temporary. By informing the client that hair loss is not permanent, the PN helps alleviate some of the client's anxiety and fear associated with the treatment. Additionally, the response prepares the client for the possibility that the color and texture of the regrown hair may be different. This information helps manage the client's expectations and provides a more comprehensive understanding of what to expect post-treatment.
Choice B reason: Stating that "we can never tell" is not the most supportive or informative response. While it is true that individual responses to chemotherapy can vary, this answer does not provide the client with any specific information or reassurance. It may leave the client feeling uncertain and anxious about the outcome. The PN's role is to provide clear and accurate information to help the client understand and cope with the effects of treatment. A more informative and empathetic response, such as choice A, is more appropriate in this context.
Choice C reason: While acknowledging that wigs are available is practical, it is not the most reassuring response. The focus on the possibility that hair might not grow back can be disheartening for the client. It is important to offer hope and positivity where possible. By emphasizing that hair loss is usually not permanent and discussing the potential changes in hair color and texture, the PN can provide a more balanced and supportive response. If the client does have concerns about wigs, this can be addressed in a separate discussion.
Choice D reason: Indicating that hair regrowth depends on the amount of drug received is somewhat accurate but lacks the reassurance and positivity provided in choice A. It is important to give the client a clearer understanding that, in most cases, hair loss from chemotherapy is temporary, and hair will generally grow back. This helps alleviate some of the stress associated with the treatment and provides a more hopeful outlook. The amount of drug and specific treatment regimens can be discussed further if the client has additional questions.