A nurse is caring for a client who just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

Have the client refrain from talking for 24 hr.

Withhold food and liquids until the client's gag reflex returns.

Irrigate the client's throat every 4 hr.

Suction the client's oropharynx frequently.

Answer and Explanation

The Correct Answer is B

A. Have the client refrain from talking for 24 hr.: This is unnecessary; the client may talk once the effects of the local anesthetic wear off, typically within an hour or two after the procedure.
B. Withhold food and liquids until the client's gag reflex returns: This is the most important action to prevent aspiration. After a bronchoscopy, the throat is anesthetized, and eating or drinking before the gag reflex returns increases the risk of aspiration.
C. Irrigate the client's throat every 4 hr.: This is not a routine post-procedure intervention and could be uncomfortable for the client.
D. Suction the client's oropharynx frequently: Suctioning should only be performed if the client has difficulty clearing secretions. There is no routine need for frequent suctioning after a bronchoscopy unless clinically indicated.

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Correct Answer is A

Explanation

A. In SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion), the body retains excessive water, leading to dilutional hyponatremia (low sodium levels). Administering hypertonic saline (3% NS) can exacerbate the condition by rapidly increasing sodium levels, which may cause demyelination of neurons (a condition called osmotic demyelination syndrome). Hypertonic saline is typically only used in severe hyponatremia with neurologic symptoms and should be carefully monitored.
B. Seizure precautions are appropriate in SIADH due to the risk of seizures from severe hyponatremia, which can lead to cerebral edema and neurological compromise.
C. Fluid restriction of 1000 mL/day is appropriate in SIADH to manage the dilutional hyponatremia by preventing further fluid retention.
D. A sodium-restricted diet is also recommended in SIADH to avoid further dilution of sodium levels and prevent worsening of hyponatremia.

A. Moon face B. Enlarged distal extremities C. Hepatomegaly D. Coarse facial features E. Loss of color discrimination

Correct Answer is ["B","C","D"]

Explanation

A. Moon face is typically associated with Cushing's syndrome, not acromegaly, which is characterized by changes in the hands, feet, and facial features rather than a rounded, moon-shaped face.
B. Enlarged distal extremities (hands and feet) are classic symptoms of acromegaly due to excessive growth hormone production.
C. Hepatomegaly (enlarged liver) is a common finding in acromegaly due to the overproduction of growth hormone, which affects organ size.
D. Coarse facial features (such as a protruding jaw, enlarged nose, and thickened lips) are a hallmark of acromegaly, resulting from the overgrowth of soft tissues.
E. Loss of color discrimination is not typically associated with acromegaly and may be seen in other conditions affecting the optic nerve or eye, but it is not a key symptom of acromegaly.

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A nurse is caring for a client who just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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