A nurse is providing discharge teaching to a client who had a laparoscopic cholecystectomy for cholecystitis. Which of the following information should the nurse include in the teaching?

"You should remain on a clear liquid diet for 1 week after surgery."

"Avoid showering for 1 week after surgery."

"Cleanse the incision sites with hydrogen peroxide."

"Apply heat to the right shoulder for pain."

Answer and Explanation

The Correct Answer is D

A) "You should remain on a clear liquid diet for 1 week after surgery.": After a laparoscopic cholecystectomy, clients do not need to remain on a clear liquid diet for a week. They can usually progress to a regular diet as tolerated, starting with light meals and avoiding fatty, greasy foods initially to prevent discomfort.

B) "Avoid showering for 1 week after surgery.": Clients are typically allowed to shower within a day or two after surgery, as long as they avoid soaking the incisions in water and follow the healthcare provider's instructions for incision care. Avoiding showering for a week is generally unnecessary and may hinder hygiene.

C) "Cleanse the incision sites with hydrogen peroxide.": Hydrogen peroxide can delay wound healing and is not recommended for routine incision care. The nurse should advise the client to cleanse the incision sites with mild soap and water and pat them dry.

D) "Apply heat to the right shoulder for pain.": Applying heat to the right shoulder can help relieve referred pain often experienced after a laparoscopic cholecystectomy due to residual gas used during the procedure. This is a common and effective method for managing postoperative discomfort.

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Correct Answer is A

Explanation

A) Administer dantrolene sodium IV: Dantrolene sodium is the treatment of choice for malignant hyperthermia. It acts as a muscle relaxant by inhibiting calcium release from the sarcoplasmic reticulum in skeletal muscles, which helps to halt the hypermetabolic crisis.

B) Monitor client for rapid decrease in heart rate: While monitoring vital signs is essential, a rapid decrease in heart rate is not a typical manifestation of malignant hyperthermia. The nurse should primarily focus on interventions to reduce hyperthermia and stabilize the client's condition.

C) Infuse chilled lactated Ringer's IV: Infusing chilled IV fluids can help lower the body temperature in malignant hyperthermia. However, this intervention is supportive and secondary to the administration of dantrolene sodium, which directly addresses the underlying pathophysiology.

D) Provide oxygen at 12 L/min via Venturi mask: Providing high-flow oxygen is necessary to manage hypoxia and metabolic acidosis associated with malignant hyperthermia. Nonetheless, this action is secondary to administering dantrolene sodium, which is crucial to stopping the hyperthermic crisis.

A. Provide detailed directions for the client's expected behavioral changes. B. Request the client write down an evaluation of personal strengths. C. List alternative interpretations of the client's illogical thinking. D. Encourage the client to participate in group recreational activities to help concentration.

Correct Answer is B

Explanation

A) Provide detailed directions for the client's expected behavioral changes
Giving detailed directions may overwhelm the client, increasing anxiety. It's more effective to offer support and simple, clear guidance to reduce stress.

B) Request the client write down an evaluation of personal strengths
Encouraging the client to focus on personal strengths can boost self-esteem and resilience, helping them cope with anxiety by promoting a positive self-image and reinforcing their ability to manage stress.

C) List alternative interpretations of the client's illogical thinking
While reframing thoughts can be helpful, this approach might be too confrontational initially. It's important to build trust and allow the client to explore thoughts at their own pace.

D) Encourage the client to participate in group recreational activities to help concentration
While recreational activities can be beneficial, they may not directly address anxiety management. Individual reflection on strengths can be a more immediate way to enhance coping skills.

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A nurse is providing discharge teaching to a client who had a laparoscopic cholecystectomy for cholecystitis. Which of the following information should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

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