A nurse at an outpatient surgery center is providing discharge instructions to a patient and their spouse following the surgical removal of a cataract.
What should the nurse include in these instructions?

Choice A rationale

While an elevated serum ammonia level can indicate liver dysfunction, it is not typically a contraindication for liver biopsy. Ammonia is a byproduct of protein metabolism and is normally converted into urea by the liver, which is then excreted in the urine. Elevated levels can occur in liver disease, but they are not typically a direct concern in the context of a liver biopsy.
Choice B rationale
A hemoglobin level of 11 g/dL is slightly low, but it is not typically a contraindication for a liver biopsy. Hemoglobin is the protein in red blood cells that carries oxygen. While a low hemoglobin level can indicate anemia, it would not typically prevent a patient from undergoing a liver biopsy.
Choice C rationale
A white blood cell count of 14.2 x 103/uL is slightly elevated, indicating a possible infection or inflammation. However, this would not typically be a contraindication for a liver biopsy.
Choice D rationale
A prothrombin time of 32 seconds is significantly prolonged, indicating a potential problem with blood clotting. This would be a major concern for a nurse caring for a patient scheduled for a liver biopsy, as the procedure involves inserting a needle into the liver and could lead to bleeding. Patients with a prolonged prothrombin time are at an increased risk of bleeding complications.

Choice A rationale
Sleep problems are a common non-gastrointestinal symptom associated with IBS345. These can include difficulty falling asleep, frequent awakenings during the night, and feeling unrefreshed upon waking.
Choice B rationale
General muscle aches are not typically associated with IBS. While some people with IBS may experience discomfort or pain in various parts of their body, these symptoms are not usually described as muscle aches.
Choice C rationale
Paresthesias, or abnormal sensations such as tingling or prickling, are not typically associated with IBS345.
Choice D rationale
Restlessness is not typically associated with IBS. However, some people with IBS may experience increased anxiety or stress, which could potentially lead to feelings of restlessness.