A female client who had bariatric surgery two weeks ago returns to the emergency department and is readmitted to the hospital because she reports experiencing nausea, vomiting, abdominal cramps, and severe diarrhea. Which intervention(s) should the nurse include in the plan of care? Select all that apply.
Plan meals with low fiber.
Separate fluids from meals.
Eliminate acidic food choices.
Offer comfort foods.
Provide small, frequent meals.
Correct Answer : A,B,E
A. Plan meals with low fiber: After bariatric surgery, the digestive system can be more sensitive, and high-fiber foods may cause discomfort. Planning low-fiber meals helps reduce irritation and minimize symptoms like diarrhea and cramping.
B. Separate fluids from meals: This is an important intervention because drinking fluids during meals can increase the risk of dumping syndrome, leading to nausea, vomiting, and diarrhea. Fluids should be consumed between meals to help avoid these symptoms.
C. Eliminate acidic food choices: Acidic foods (like citrus, tomatoes, some sauces) can irritate the sensitive gastric pouch and small intestine after bariatric surgery, potentially exacerbating symptoms of nausea, abdominal cramps, and discomfort.
D. Offer comfort foods: Comfort foods are not appropriate for this client, as they may be high in fat, sugar, or calories, which could exacerbate symptoms after bariatric surgery. Instead, nutritious and easily digestible foods should be offered.
E. Provide small, frequent meals: Offering small, frequent meals helps reduce the strain on the digestive system, making it easier for the client to tolerate food. Large meals can cause discomfort and increase the risk of complications such as dumping syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hydrocortisone: Addison’s disease is characterized by insufficient cortisol production. The client’s symptoms, including weakness, confusion, and dehydration, along with laboratory values indicating low sodium, low glucose, and elevated potassium, suggest an adrenal crisis. Hydrocortisone is the primary.
B. Regular insulin: Regular insulin is used to lower blood glucose levels, but the client’s glucose level is already low, not high. Insulin could worsen the client's hypoglycemia. The focus should be on correcting the cortisol deficiency rather than administering insulin.
C. Broad spectrum antibiotic: While antibiotics may be needed if there’s a concern for infection, there’s no evidence of active infection here. The priority is addressing the client's Addisonian crisis, which is primarily treated with hydrocortisone, not antibiotics.
D. Potassium chloride: The client's potassium is elevated (5.3 mEq/L), but potassium chloride is not indicated in this case. The priority is to manage the underlying adrenal crisis, which will address the electrolyte imbalance.
Correct Answer is ["A","B","D","G","H"]
Explanation
A. Occupation of legal secretary: The client works as a legal secretary, which may involve extensive typing or repetitive hand movements. This can contribute to musculoskeletal stress or strain, potentially exacerbating symptoms like pain and stiffness in the hands.
B. Stiffness in hands for 3 months: The client reports stiffness in both hands and wrists for the past 3 months, which could suggest an inflammatory arthritis such as rheumatoid arthritis (RA). This warrants further evaluation, especially given her family history of arthritis.
C. Radial and pedal pulses 2+: A rating of 2+ for radial and pedal pulses is normal, indicating no circulation issues, and does not need further evaluation.
D. Pain in bilateral hands and wrists: Persistent, symmetrical pain in the hands and wrists, particularly with palpation, may indicate a condition like rheumatoid arthritis. This symptom, in combination with morning stiffness, needs further investigation.
E. History of asthma using albuterol inhaler PRN: The client's history of well-controlled asthma, managed with an albuterol inhaler as needed for exacerbations, does not directly relate to her current presentation of hand pain and stiffness.
F. Capillary refill 2 seconds: A capillary refill time of 2 seconds is within the normal range, indicating adequate peripheral perfusion. This finding suggests that there are no immediate circulatory issues contributing to her hand pain and stiffness and does not require further evaluation.
G. Body mass index (BMI) of 31 kg/m²: A BMI of 31 falls within the obese range, which can increase the risk for musculoskeletal issues and other chronic conditions. This factor should be evaluated further, as obesity may affect joint health.
H. Client's hobbies: The client enjoys hobbies like gardening and crocheting, which involve repetitive hand movements. These activities could exacerbate the pain and stiffness in her hands, making it important to evaluate whether these hobbies are contributing to her symptoms.
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