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) Insert a pillow under the client's knees: While placing a pillow under the knees may promote comfort, it can lead to increased pressure on the lower back and may not effectively address potential compression of the vena cava, which is crucial in maintaining optimal placental blood flow during surgery.

B) Assist the client into the lithotomy position: The lithotomy position can increase pressure on the abdominal vessels, potentially compromising blood flow to the placenta. This position should be used cautiously, especially in clients with concerns regarding blood flow.

C) Place a wedge under one of the client's hips: This action is appropriate as it helps to displace the uterus laterally, reducing pressure on the inferior vena cava. This maneuver improves venous return and maintains placental perfusion, which is critical during cesarean delivery.

D) Position the client in reverse Trendelenburg: Although this position elevates the upper body, it does not specifically address the potential for vena cava compression caused by the weight of the uterus. It is less effective than placing a wedge under the hips in terms of preserving placental blood flow.

A. "I will need to keep my hand elevated above my heart for several days." B. "I should expect numbness and tingling in my hand." C. "I should not use my affected hand for 4 to 6 weeks." D. "I can apply heat for the first 24 hours to minimize the pain in my hand."

Correct Answer is A

Explanation

A) “I will need to keep my hand elevated above my heart for several days.”: Elevating the hand above the heart helps reduce swelling and pain after surgery. This practice is crucial for promoting proper healing and minimizing discomfort.

B) “I should expect numbness and tingling in my hand.”: Numbness and tingling are not expected outcomes and could indicate complications. These symptoms should be reported to the healthcare provider for further evaluation.

C) “I should not use my affected hand for 4 to 6 weeks.”: Complete restriction of hand use for 4 to 6 weeks is unnecessary and could lead to stiffness and decreased function. Gradual use and movement are encouraged to aid recovery.

D) “I can apply heat for the first 24 hours to minimize the pain in my hand.”: Applying heat in the first 24 hours can increase swelling and should be avoided. Cold therapy is recommended initially to reduce inflammation and pain.

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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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