A nurse is caring for a client 8 hr postoperative following a total knee replacement. Which of the following actions should the nurse take?

Encourage increased fluid take.

Promote bed rest for 5-7 days.

Place a pillow under the affected limb.

Apply cool compresses to the affected limb every 6 hr.

Answer and Explanation

The Correct Answer is D

A.   Encouraging adequate fluid intake is important postoperatively to maintain hydration and support normal physiological functions. However, the amount of fluid intake should be within the client's tolerance and as prescribed by the healthcare provider. It helps prevent complications such as dehydration and promotes circulation, which is beneficial for wound healing.

B.   While some rest and limited mobility are initially recommended after knee replacement surgery to allow for healing and to prevent complications, prolonged bed rest for 5-7 days is not typically necessary or recommended. Early mobilization and gradual increase in activity are encouraged to prevent complications such as deep vein thrombosis and to promote recovery.
C.   Placing a pillow directly under the knee is not recommended as it can lead to decreased range of motion and potential contractures.
D.   Cold therapy, such as applying cool compresses, is often used to reduce swelling and pain in the initial postoperative period. It can help manage pain and discomfort and promote comfort for the client.

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Correct Answer is B

Explanation

A. Offering ice chips, might seem like a safe alternative, but it still poses a risk if the gag reflex is not intact.
B. Assessing the gag reflex is crucial before offering food or fluids to ensure the client can protect their airway and swallow safely. This response prioritizes safety and is appropriate to ensure the client does not aspirate.
C. Calling the healthcare provider to request orders for food and water may be necessary if there are specific protocols or if the client's condition requires further assessment or interventions before oral intake can be resumed. However, this response does not address the immediate need for comfort and hydration.
D. This response involves assessing the client's ability to swallow directly. While it addresses the client's request for water, it may not be the safest initial approach without first assessing the client's readiness and ability to swallow safely.

A. Respiratory alkalosis B. Metabolic acidosis C. Metabolic alkalosis D. Respiratory acidosis

Correct Answer is D

Explanation

A. Respiratory alkalosis is characterized by a high pH (alkaline) and a low PaCO2 (<35 mm Hg). The ABG results provided show a pH of 7.3 (which is acidic) and a PaCO2 of 50 mm Hg (which is elevated). Therefore, these results do not indicate respiratory alkalosis.
B. Metabolic acidosis is characterized by a low pH (<7.35) and a decreased bicarbonate (HCO3-). The ABG results show a pH of 7.3 (acidic), which aligns with metabolic acidosis. However, the PaCO2 of 50 mm Hg is elevated, which typically indicates respiratory compensation for the metabolic acidosis.
C. Metabolic alkalosis is characterized by a high pH and an elevated bicarbonate (HCO3-). The ABG results show a pH of 7.3 (acidic), which does not suggest metabolic alkalosis.
D. Respiratory acidosis is characterized by a low pH and an elevated PaCO2 (>45 mm Hg). The ABG results provided show a pH of 7.3 (acidic) and a PaCO2 of 50 mm Hg (elevated). These findings are consistent with respiratory acidosis, where the elevated PaCO2 indicates retention of carbon dioxide, leading to acidosis.

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A nurse is caring for a client 8 hr postoperative following a total knee replacement. Which of the following actions should the nurse take?

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