A nurse is planning care for a male client who is postoperative following a hernia repair. Which of the following actions should the nurse include in the plan?

Elevate the client's scrotum on a pillow.

Restrict fluids to 1,200 mL per day.

Place a warm pack on the incisional area.

Encourage the client to sit to void.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Elevate the client's scrotum on a pillow: After hernia repair, scrotal elevation helps reduce swelling and promote venous return, minimizing postoperative edema and discomfort. Supporting the scrotum with a pillow or rolled towel also decreases tension on the incision site, enhancing comfort and healing.

B. Restrict fluids to 1,200 mL per day: Fluid restriction is not indicated for clients following hernia repair unless there is a concurrent condition such as renal or cardiac impairment. Adequate hydration is essential to prevent constipation and promote tissue recovery after surgery.

C. Place a warm pack on the incisional area: Warm packs should be avoided immediately after surgery because they can increase local blood flow and risk of bleeding at the incision site. Cold packs may be used instead to reduce swelling and provide comfort.

D. Encourage the client to sit to void: Male clients are encouraged to stand when voiding to reduce intra-abdominal pressure on the surgical site. Sitting to void may increase pressure on the repaired area, potentially causing discomfort or strain on the incision.

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Correct Answer is A

Explanation

Rationale:
A. Gently push the syringe plunger to administer medication: Medications given via NG tube should be administered slowly and gently using a syringe to avoid tube damage, aspiration, or sudden changes in gastric pressure. This technique ensures safe and effective delivery of the medication.

B. Dissolve the medications together: Mixing multiple medications can cause chemical interactions or precipitation, which can block the NG tube or reduce medication efficacy. Each medication should be dissolved and administered separately.

C. Flush the NG tube with 5 mL of cold tap water after administration: Flushing is necessary to maintain tube patency, but 5 mL is insufficient for continuous feedings. Typically, 15–30 mL of warm or room-temperature water is used to prevent tube occlusion.

D. Add medication directly to the enteral feeding: Adding medication to the feeding can alter the composition, affect absorption, and create a risk for tube blockage. Medications should be given separately with flushing before and after administration.

A. Limit teaching sessions about the procedure to 20 min. B. Ask the parents to wait outside the room during the procedure. C. Instruct the child in deep-breathing methods prior to the procedure. D. Explain in simple terms how the procedure will affect the child.

Correct Answer is D

Explanation

Rationale:
A. Limit teaching sessions about the procedure to 20 min: While preschoolers have limited attention spans, the focus should be on using age-appropriate language and explanations rather than strictly timing the teaching session. The quality and clarity of instruction are more important.

B. Ask the parents to wait outside the room during the procedure: Preschoolers often feel safer and more cooperative when a parent is present. Removing parents can increase anxiety and resistance, so parental presence is encouraged.

C. Instruct the child in deep-breathing methods prior to the procedure: Deep-breathing exercises can help with relaxation, but preschoolers may have difficulty understanding or performing them effectively. Simple explanations and reassurance are more appropriate.

D. Explain in simple terms how the procedure will affect the child: Providing a clear, age-appropriate explanation helps the preschooler understand what to expect, reduces fear, and promotes cooperation. Using simple terms tailored to the child’s developmental level is the most effective preparation.

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A nurse is planning care for a male client who is postoperative following a hernia repair. Which of the following actions should the nurse include in the plan?

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