A nurse is planning care for a client who is returning to the unit following open gastric bypass surgery. Which of the following interventions should the nurse include in the client's plan of care?

Ambulate the client 48 hr after the procedure.

Provide a soft diet on the first postoperative day.

Provide 60 mL (2 oz) of fluid intake every 5 min.

Measure and compare abdominal girth daily.

Answer and Explanation

The Correct Answer is D

A) Ambulate the client 48 hr after the procedure: Early ambulation is important to prevent complications such as deep vein thrombosis and promote recovery. However, ambulating the client 48 hours after the procedure may be too late. Early mobilization, usually within the first 24 hours, is encouraged.

B) Provide a soft diet on the first postoperative day: After gastric bypass surgery, the client typically starts with clear liquids and gradually progresses to a soft diet. Providing a soft diet on the first postoperative day is not appropriate and could cause complications.

C) Provide 60 mL (2 oz) of fluid intake every 5 min: Fluid intake should be carefully monitored and gradually increased. Providing 60 mL of fluid every 5 minutes is excessive and could lead to discomfort or complications such as dumping syndrome.

D) Measure and compare abdominal girth daily: Measuring and comparing abdominal girth daily helps monitor for signs of complications such as internal bleeding or anastomotic leaks. This intervention is crucial for early detection and prompt management of potential issues

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Correct Answer is C

Explanation

A) "I will use an enema to manage my constipation.": This statement is concerning because enemas can cause trauma to the rectal mucosa, which may lead to bleeding in a client with thrombocytopenia. Therefore, this action is not advisable and indicates a lack of understanding of safe practices.

B) "I will remove my shoes when I'm inside my house.": While removing shoes can help maintain cleanliness, it does not directly relate to managing thrombocytopenia or preventing bleeding. This statement does not reflect an understanding of the specific precautions needed for a client with low platelet counts.

C) "I will wipe my nose instead of blowing it.": This statement demonstrates an understanding of the need to minimize trauma to the nasal passages. Blowing the nose can increase the risk of bleeding in individuals with thrombocytopenia, so wiping is a safer alternative.

D) "I will floss between my teeth every time I brush.": Flossing can be harmful for a person with thrombocytopenia, as it may cause gum bleeding. Clients are often advised to avoid flossing to reduce the risk of bleeding, indicating that this statement reflects a misunderstanding of appropriate oral care practices for their condition.

A. Increase intake of milk products. B. Sweeten foods with fructose corn syrup. C. Increase intake of foods high in gluten. D. Consume foods high in fiber.

Correct Answer is D

Explanation

A) Increase intake of milk products: Many individuals with irritable bowel syndrome (IBS) may experience lactose intolerance, leading to bloating and discomfort from milk products. Therefore, increasing dairy intake is not typically recommended.

B) Sweeten foods with fructose corn syrup: Fructose can exacerbate symptoms in some people with IBS, as it can lead to digestive upset. Instead, it’s best to limit foods high in fructose corn syrup.

C) Increase intake of foods high in gluten: Gluten may cause issues for individuals with specific sensitivities or celiac disease, and for some with IBS, it may trigger symptoms. Thus, increasing gluten intake is not advisable.

D) Consume foods high in fiber: Increasing dietary fiber is generally recommended for individuals with IBS, as it can help regulate bowel movements and improve overall digestive health. Soluble fiber, in particular, is beneficial and can help alleviate symptoms.

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A nurse is planning care for a client who is returning to the unit following open gastric bypass surgery. Which of the following interventions should the nurse include in the client's plan of care?

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