A nurse is caring for a client who has a Jackson-Pratt drain in place after surgery for an open reduction and internal fixation. The nurse should understand that the JP drain was placed for which of the following purposes?
To eliminate the need for wound irrigations.
To limit the amount of bleeding from the surgical site.
To prevent fluid from accumulating in the wound.
To provide a means for medication administration.
The Correct Answer is C
Choice A reason:
The purpose of a Jackson-Pratt (JP) drain is not to eliminate the need for wound irrigations. Wound irrigation is a critical step in wound care that helps remove debris, reduce bacterial load, and create an optimal environment for healing. The JP drain helps manage fluid accumulation but does not replace the need for proper wound irrigation.
Choice B reason:
While a JP drain can help manage bleeding by providing a pathway for blood to exit the wound, its primary purpose is not to limit bleeding. Instead, it is designed to prevent the accumulation of fluids such as blood, serous fluid, and other exudates that can impede healing and increase the risk of infection. Managing bleeding typically involves other interventions such as surgical hemostasis techniques.
Choice C reason:
The primary purpose of a Jackson-Pratt drain is to prevent fluid from accumulating in the wound. After surgery, wounds can produce various fluids, including blood and lymphatic fluid. Accumulation of these fluids can delay healing and increase the risk of infection. The JP drain uses gentle suction to draw these fluids away from the wound site, promoting faster healing and reducing the risk of complications.
Choice D reason:
A JP drain is not typically used to provide a means for medication administration. Medications are usually administered through other routes such as oral, intravenous, or through specialized catheters designed for medication delivery. The JP drain is specifically designed for fluid drainage and not for delivering medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Taking aspirin while on prednisone can increase the risk of gastrointestinal bleeding. Prednisone, a corticosteroid, can cause stomach irritation, and combining it with aspirin, a nonsteroidal anti-inflammatory drug (NSAID), can exacerbate this effect. Therefore, clients should avoid taking aspirin for minor aches and pains while on prednisone.
Choice B reason: A sore throat is not a common side effect of prednisone. Prednisone can suppress the immune system, making clients more susceptible to infections, but it does not typically cause a sore throat within the first week of use. If a client experiences a sore throat, they should contact their healthcare provider as it may indicate an infection.
Choice C reason: Clients on prednisone should avoid live vaccines, such as the flu vaccine, within one week of starting the medication. Prednisone can weaken the immune system, reducing the effectiveness of the vaccine and increasing the risk of developing the illness the vaccine is meant to prevent. It is generally recommended to consult with a healthcare provider before receiving any vaccines while on prednisone.
Choice D reason: Prednisone can cause potassium loss, leading to hypokalemia. Eating more bananas, which are high in potassium, can help counteract this effect and maintain normal potassium levels. Normal potassium levels range from 3.5 to 5.0 mEq/L. Therefore, clients should increase their intake of potassium-rich foods like bananas while taking prednisone.
Correct Answer is D
Explanation
Choice A reason:
The statement “The nurse identifies a broken piece of equipment” is important for safety and should be reported to the appropriate department for repair or replacement. However, it does not typically require an incident report unless the broken equipment caused harm or had the potential to cause harm to a patient. Incident reports are generally used to document events that are not consistent with the routine operation of the healthcare unit or the standard care of a patient.
Choice B reason:
The statement “The nurse has a disagreement with the nursing supervisor about inadequate staffing” reflects an internal issue that should be addressed through appropriate channels, such as a staff meeting or a discussion with human resources. It does not typically require an incident report unless the disagreement led to a situation that compromised patient safety or care. Incident reports are meant to document events that directly affect patient care and safety.
Choice C reason:
The statement “A staff member does not show up to work her assigned shift” is a staffing issue that should be managed by the nursing supervisor or the staffing coordinator. While it can affect the workflow and staffing levels, it does not usually require an incident report unless it directly impacts patient care or safety. Incident reports are used to document specific events that deviate from standard care practices and have the potential to harm patients.
Choice D reason:
The statement “A client discovers that his dentures are missing” is a situation that requires an incident report. The loss of a client’s personal belongings, especially something as essential as dentures, can significantly impact the client’s well-being and quality of care. Documenting this incident helps to investigate the circumstances, prevent future occurrences, and ensure that appropriate measures are taken to address the client’s needs. Incident reports are crucial for tracking and addressing issues that affect patient care and safety.
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