A nurse is caring for a patient who is 1 day postoperative following a cholecystectomy. The nurse suspects the patient's wound is infected because the drainage from the dressing is yellow and thick. Which of the following findings should the nurse report as the type of drainage found?
Serosanguineous
Serous
Purulent
Sanguineous
The Correct Answer is C
Choice A reason: Serosanguineous drainage is a mixture of blood and clear fluid, not typically yellow and thick.
Choice B reason: Serous drainage is clear and watery, not yellow and thick.
Choice C reason: Purulent drainage is typically yellow and thick, indicating the presence of pus, which can be a sign of infection.
Choice D reason: Sanguineous drainage is fresh bleeding, bright red in color, not yellow and thick.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Elevating the patient in a high Fowler's position can help improve lung expansion and oxygenation, and using an incentive spirometer along with coughing can help prevent atelectasis and pneumonia, which are common postoperative complications.
Choice B reason: Increasing oxygen to 70% without a specific indication could lead to oxygen toxicity, especially without assessing the patient's current oxygenation status.
Choice C reason: Switching to a rebreather mask is not indicated based on the given ABG results and could lead to CO2 retention.
Choice D reason: Positioning the patient prone and performing postural drainage are not typically first-line interventions for a patient one day post-thoracotomy and could be contraindicated due to the recent surgery.
Correct Answer is A
Explanation
Choice A reason: Hyperventilation is a common response to respiratory alkalosis as the body tries to compensate for the high pH by exhaling more carbon dioxide.
Choice B reason: Dyspnea, or difficulty breathing, may be present but is not as specific as hyperventilation for respiratory alkalosis.
Choice C reason: Abdominal pain is not typically associated with respiratory alkalosis.
Choice D reason: Dizziness can be a symptom of respiratory alkalosis due to changes in blood chemistry, but it is less specific than hyperventilation.
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