A nurse is assisting with the care of a client who has cirrhosis of the liver with ascites. Which of the following actions should the nurse take?

Position the client flat in bed.

Weigh the client weekly.

Medicate the client with acetaminophen for discomfort.

Measure the client’s abdominal girth every 8 hours.

Answer and Explanation

The Correct Answer is D

a. Position the client flat in bed: This position may increase pressure on the abdomen and exacerbate ascites. The head of the bed should be elevated to enhance respiratory function.

b. Weigh the client weekly: Weighing the client daily is more appropriate to monitor fluid retention and assess the effectiveness of interventions.

c. Medicate the client with acetaminophen for discomfort: While acetaminophen can be used for pain relief, its use should be monitored closely due to the potential for liver toxicity in clients with cirrhosis.

d. Measure the client’s abdominal girth every 8 hours: Monitoring abdominal girth is crucial for assessing the degree of ascites and evaluating the effectiveness of interventions.

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Correct Answer is A

Explanation

a. Instruct the client to place his chin to his chest and swallow: This technique helps facilitate the passage of the nasogastric tube through the pharynx and into the esophagus.

b. Withdraw the tube if the client gags during insertion: Gagging is a normal response, and

withdrawing the tube may lead to repeated attempts and discomfort for the client. Encouraging the client to swallow can help overcome the gag reflex.

c. Place the client in a supine position: The client is usually positioned in a semi-Fowler's position or upright to ease tube insertion and minimize the risk of aspiration.

d. Measure the tube for insertion from the tip of the nose to the umbilicus: The proper

measurement for nasogastric tube insertion is typically from the tip of the nose to the earlobe and then down to the xiphoid process, not the umbilicus.

A. “Managing my cholesterol will reduce my chances of having a stroke.” B. “My blood pressure needs to stay a little elevated for good blood flow to my brain.” C. “Using oral contraceptives provides me with protection from a stroke.” D. “I can safely have up to 3 alcoholic drinks a day.”

Correct Answer is A

Explanation

a. “Managing my cholesterol will reduce my chances of having a stroke.”: High cholesterol is a risk factor for stroke, and managing it can help reduce the risk.

b. “My blood pressure needs to stay a little elevated for good blood flow to my brain.”:

Maintaining normal blood pressure is essential for preventing stroke, and elevated blood pressure is a risk factor for stroke.

c. “Using oral contraceptives provides me with protection from a stroke.”: Oral contraceptives, especially in the presence of other risk factors, can increase the risk of stroke.

d. “I can safely have up to 3 alcoholic drinks a day.”: Excessive alcohol consumption is a risk factor for stroke, and moderation is advised to reduce the risk.

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