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 A

Explanation

A) "Practice pelvic-floor exercises regularly.": This instruction is essential for bladder retraining. Pelvic-floor exercises, such as Kegel exercises, strengthen the muscles that support the bladder and can help improve control over incontinence.

B) "Wear a pair of disposable briefs at bedtime.": While using disposable briefs can provide comfort and protection, this approach does not contribute to bladder retraining. It may inadvertently allow the client to rely on them instead of focusing on improving bladder control.

C) "Limit oral fluid intake to 1,000 milliliters per day.": Limiting fluid intake is generally not recommended, as it can lead to concentrated urine and potential bladder irritation. Adequate hydration is important for overall health and can help maintain normal bladder function.

D) "Drink 8 ounces of citrus juice per day.": Citrus juices can irritate the bladder in some individuals, leading to increased urgency and frequency. It’s usually advisable to avoid such irritants during bladder retraining, making this instruction less appropriate.

A. Don sterile gloves prior to the procedure. B. Apply EMLA cream prior to the procedure. C. Obtain a 12-French catheter. D. Discard the first 10 mL of urine.

Correct Answer is A

Explanation

A) Donning sterile gloves prior to the procedure is essential to maintain a sterile field and prevent contamination during catheterization. This practice is critical for ensuring the accuracy of the urine culture by avoiding the introduction of bacteria from the environment.

B) While EMLA cream can be used to numb the area and minimize discomfort, it is not a required step for catheterization in toddlers and may not always be available or necessary. The primary focus should be on maintaining sterility during the procedure.

C) A 12-French catheter may be too large for a toddler, who typically requires a smaller catheter size (usually 8-10 French) to minimize trauma and discomfort. Using the appropriate size is crucial for ensuring a successful procedure.

D) Discarding the first 10 mL of urine is not standard practice for urine cultures obtained via catheterization, as the first portion of urine collected is typically the cleanest and most reflective of the bladder contents. For accurate culture results, the initial sample should be collected and sent for testing.

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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?

Nursing Test Bank

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