A nurse is providing discharge teaching to an older adult client following a left total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?

"You should use an incentive spirometer every 8 hours."

"Clean the incision daily with hydrogen peroxide."

"You can cross your legs at the ankles when sitting down."

"Install a raised toilet seat in your bathroom."

Answer and Explanation

The Correct Answer is D

Rationale:

A. "You should use an incentive spirometer every 8 hours." Using an incentive spirometer is important for preventing respiratory complications, but the recommendation should be to use it every 1-2 hours while awake, not just every 8 hours.

B. "Clean the incision daily with hydrogen peroxide." Hydrogen peroxide is too harsh for wound care and can delay healing by damaging new tissue. The incision should be cleaned with mild soap and water or as directed by the healthcare provider.

C. "You can cross your legs at the ankles when sitting down." After a hip replacement, clients should avoid crossing their legs, especially at the knees, to prevent dislocation of the new hip joint.

D. "Install a raised toilet seat in your bathroom." After hip replacement surgery, the client should avoid bending the hip beyond 90 degrees to reduce the risk of dislocation. Installing a raised toilet seat helps the client maintain proper positioning and avoid hip flexion beyond the recommended limit.

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Correct Answer is D

Explanation

Rationale:

A. "I am sure you will be able to still spend time with your grandchildren." While reassurance is important, this statement may not be realistic, and it does not acknowledge the client’s feelings of uncertainty. The client may need more support and guidance regarding their post-surgery recovery and limitations.

B. "Why do you think you won't be able to play with your grandchildren?" This question may sound confrontational or dismissive of the client’s concerns. It is more important to validate the client’s emotions and explore their feelings in a non-judgmental way..

C. "You will not be as active for a couple of years." This statement is overly negative and does not provide an opportunity to explore the client’s emotional needs. Recovery from knee arthroplasty varies and focusing on long-term inactivity could discourage the client.

D. "What are some of the activities you like to do with your grandchildren?" This open-ended question validates the client’s feelings and helps shift the focus towards their interests and goals. It allows the nurse to explore realistic expectations and discuss ways to resume activities after recovery, fostering a positive outlook.

A. Anticipate client to be prepped for cardiac catheterization. B. Assist with a continuous heparin infusion. C. Encourage the client to ambulate. D. Anticipate an increased dosage of metoprolol. E. Obtain a prescription for client to be NPO. F. Request a prescription for an antibiotic.

Correct Answer is ["A","B","E"]

Explanation

Rationale:

A. Anticipate client to be prepped for cardiac catheterization: The client has been diagnosed with a myocardial infarction (MI) based on echocardiogram results. Cardiac catheterization is a next step to assess for blockages in coronary arteries and to guide potential interventions like angioplasty or stent placement.

B. Assist with a continuous heparin infusion: Heparin is commonly used in patients with myocardial infarction to prevent further clot formation and reduce the risk of additional thrombotic events.

C. Encourage the client to ambulate: Ambulation is not recommended during the acute phase of a myocardial infarction. The priority is to stabilize the patient and minimize physical exertion to reduce myocardial stress.

D. Anticipate an increased dosage of metoprolol: The client's 1200 vital signs show a blood pressure of 110/62 mm Hg, which is significantly lower than the 1000 and 1015 readings (164/80 and 176/82 respectively) which does not indicate the need for an increased dose.

E. Obtain a prescription for client to be NPO: The client may be prepped for a cardiac catheterization or other surgical procedures, which generally require the client to be NPO to reduce the risk of aspiration.

F. Request a prescription for an antibiotic: There is no indication of an infection requiring antibiotics. Antibiotics would be prescribed only if there is a clear indication of infection.

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A nurse is providing discharge teaching to an older adult client following a left total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postoperative following a total knee arthroplasty. The client tells the nurse, "I will not be able to play with my grandchildren anymore." Which of the following responses should the nurse make?

Correct Answer is D

Explanation

The nurse is reviewing the client's medical record. Exhibits A nurse is reviewing the client's diagnostic results and vital signs. Which of the following actions should the nurse take? Select all that apply.

Correct Answer is ["A","B","E"]

Explanation

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