A nurse is caring for a client who had a laparoscopic cholecystectomy. Which of the following interventions should the nurse implement to prevent postoperative nausea and vomiting?

Administer an antiemetic as ordered.

Encourage the client to drink carbonated beverages.

Place the client in a supine position.

Apply pressure to the client's abdomen.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Administering an antiemetic as ordered can help prevent postoperative nausea and vomiting by blocking the receptors in the brain that trigger the vomiting reflex. This is a common intervention for clients who have undergone laparoscopic cholecystectomy, as they may experience nausea and vomiting due to the effects of anesthesia, pain, or the carbon dioxide gas used to inflate the abdomen during the procedure.

Choice B reason:

Encouraging the client to drink carbonated beverages is not a good intervention to prevent postoperative nausea and vomiting, as carbonated beverages can increase gastric distension and pressure, which can worsen nausea and vomiting. Carbonated beverages can also cause belching, which can introduce air into the stomach and increase the risk of aspiration.

Choice C reason:

Placing the client in a supine position is not a good intervention to prevent postoperative nausea and vomiting, as supine position can decrease gastric emptying and increase the risk of aspiration. Supine position can also impair respiratory function and cause hypoxemia, which can trigger nausea and vomiting. The client should be placed in a semi-Fowler's position or on their side with their head elevated to facilitate gastric emptying and prevent aspiration.

Choice D reason:

Applying pressure to the client's abdomen is not a good intervention to prevent postoperative nausea and vomiting, as pressure can cause pain and discomfort, which can worsen nausea and vomiting. Pressure can also interfere with wound healing and increase the risk of infection or bleeding. The client's abdomen should be assessed for distension, tenderness, or signs of complications, but not pressed.

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Correct Answer is A

Explanation

Choice A reason:

Tingling in the fingers and toes is a sign of paresthesia, which is a common symptom of hypocalcemia. Hypocalcemia occurs when the blood calcium level is too low, which can happen after a thyroidectomy if the parathyroid glands are damaged or removed. The parathyroid glands produce parathyroid hormone, which regulates calcium balance in the body. Without enough parathyroid hormone, calcium levels drop and cause neuromuscular irritability and numbness or tingling sensations.

Choice B reason:

Difficulty swallowing and speaking is not a specific sign of hypocalcemia, but rather a possible complication of a thyroidectomy due to injury to the recurrent laryngeal nerve. This nerve innervates the muscles of the larynx, which control voice production and swallowing. Damage to this nerve can cause hoarseness, weak voice, or vocal cord paralysis.

Choice C reason:

Dry mouth and increased thirst are not signs of hypocalcemia, but rather signs of dehydration. Dehydration can occur for various reasons, such as fluid loss, inadequate fluid intake, or increased fluid needs. Dehydration can affect the electrolyte balance in the body, but it does not directly cause hypocalcemia.

Choice D reason:

Muscle weakness and fatigue are not specific signs of hypocalcemia, but rather general signs of malaise. Malaise can occur for various reasons, such as infection, inflammation, stress, or chronic illness. Malaise can affect the physical and mental well-being of a person, but it does not directly cause hypocalcemia.

A. "I will start with gentle shoulder shrugs and circles.” B. "I will lift my arm above my head several times a day.” C. "I will use my affected arm for normal activities as much as possible.” D. "I will wear a compression sleeve on my affected arm.”

Correct Answer is C

Explanation

Choice A reason:

This is incorrect because gentle shoulder shrugs and circles are not enough to prevent lymphedema and promote mobility. The client needs to perform more active and progressive exercises that involve the full range of motion of the shoulder joint.

Choice B reason:

This is incorrect because lifting the arm above the head several times a day is too aggressive and may cause swelling and pain. The client should gradually increase the elevation of the arm over several weeks, starting with 90 degrees and then progressing to 120 degrees.

Choice C reason:

This is correct because using the affected arm for normal activities as much as possible helps to restore function and prevent stiffness. The client should avoid heavy lifting, tight clothing, blood pressure measurements, and injections on the affected arm, but otherwise should use it for daily tasks such as combing hair, dressing, and eating.

Choice D reason:

This is incorrect because wearing a compression sleeve on the affected arm is not recommended for routine use after a mastectomy. Compression sleeves are only indicated for clients who have developed lymphedema and need to reduce the swelling. They may also be used for air travel or strenuous exercise, but only with a physician's prescription.

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A nurse is caring for a client who had a laparoscopic cholecystectomy. Which of the following interventions should the nurse implement to prevent postoperative nausea and vomiting?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who had a thyroidectomy. The nurse suspects that the client is experiencing hypocalcemia due to inadvertent damage to the parathyroid glands. Which of the following statements by the client supports this suspicion?

Correct Answer is A

Explanation

A nurse is preparing a client for discharge after a mastectomy. The nurse teaches the client how to perform arm exercises to prevent lymphedema and promote mobility. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is C

Explanation

A nurse is caring for a client who had a laparoscopic cholecystectomy. Which of the following interventions should the nurse implement to prevent postoperative nausea and vomiting?

A nurse is reviewing the discharge instructions for a client who had a total hip replacement. Which of the following statements by the client indicate a need for further teaching? (Select all that apply.)

A nurse is caring for a client who had an abdominal hysterectomy. The nurse observes that the client has a low-grade fever, foul-smelling vaginal discharge and lower abdominal tenderness. Which of the following actions should the nurse take first?