A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy. Which of the following instructions should the nurse include in the teaching?

Wear a bra with wire support.

Use deodorant under the affected arm.

Begin ball squeezing exercises.

Avoid using the affected arm for eating.

Answer and Explanation

The Correct Answer is D

A. Wear a bra with wire support: This is not recommended immediately after a modified radical mastectomy, as it can put pressure on the surgical site and cause discomfort or interfere with healing. Instead, the client should wear a soft, supportive bra without underwire to provide comfort and support.
B. Use deodorant under the affected arm: Applying deodorant under the affected arm is generally not recommended immediately after surgery, as the area may be sensitive and the skin may be healing. The client should avoid applying deodorant until the surgical site has healed and they have consulted with their healthcare provider.
C. Begin ball squeezing exercises: While exercises to improve range of motion and strength in the affected arm are important after a mastectomy, initiating them on the first day postoperative may be too early. The client should follow the specific instructions provided by their healthcare provider regarding when to begin exercises and which exercises are appropriate.
D. Avoid using the affected arm for eating: This is the most appropriate instruction for the client. After a modified radical mastectomy, the affected arm may be temporarily restricted in movement or may be sensitive. To avoid strain or discomfort, the client should avoid using the affected arm for activities such as eating until they receive further guidance from their healthcare provider.

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Correct Answer is D

Explanation

D. "During this test, I will push a button if my baby moves."

Rationale:
A. "This test will tell me if my baby has a genetic problem." - Nonstress testing (NST) is used to evaluate fetal well-being by assessing fetal heart rate accelerations in response to fetal movement. It does not diagnose genetic problems.
B. "I will get oxytocin during this test." - Oxytocin is not typically administered during nonstress testing. NST is a non-invasive procedure that involves placing a fetal heart rate monitor on the mother's abdomen to monitor the baby's heart rate.
C. "During this test, I must not eat or drink anything." - While it's generally recommended to have a snack or meal before the test to encourage fetal movement, fasting is not required for NST unless otherwise instructed by the healthcare provider.
D. "During this test, I will push a button if my baby moves." - This statement demonstrates an understanding of how NST works. The client is instructed to push a button whenever they feel fetal movement, allowing the healthcare provider to correlate fetal movement with changes in the fetal heart rate pattern.

A. The client's heart rate increases by 10/min. B. The client's systolic blood pressure decreases by 25 mm Hg. C. The client's diastolic blood pressure increases by 10 mm Hg. D. The client reports heart palpitations.

Correct Answer is B

Explanation

A. The client's heart rate increases by 10/min: An increase in heart rate upon changing positions may occur as a compensatory mechanism to maintain blood pressure, but it is not indicative of orthostatic hypotension. Orthostatic hypotension is characterized by a decrease in blood pressure upon assuming an upright position.
B. The client's systolic blood pressure decreases by 25 mm Hg: Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or more, or a decrease in diastolic blood pressure of 10 mm Hg or more, within 3 minutes of standing up from a supine position. Therefore, a decrease in systolic blood pressure by 25 mm Hg upon changing positions is consistent with orthostatic hypotension.
C. The client's diastolic blood pressure increases by 10 mm Hg: Orthostatic hypotension typically involves a decrease in both systolic and diastolic blood pressure upon assuming an upright position. An increase in diastolic blood pressure is not consistent with orthostatic hypotension.
D. The client reports heart palpitations: Heart palpitations may occur due to various reasons, such as anxiety or cardiac arrhythmias, but they are not specific to orthostatic hypotension. While orthostatic hypotension may cause symptoms like dizziness or lightheadedness, heart palpitations are not typically associated with this condition.

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A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy. Which of the following instructions should the nurse include in the teaching?

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