A nurse is providing preoperative teaching for a patient who is scheduled for a gastrectomy.
Which of the following information regarding the prevention of postoperative complications should the nurse include in the teaching?
Teach the client how to use the PCA pump.
Instruct the client on coughing and deep breathing exercises.
Explain the importance of early ambulation.
Discuss the use of incentive spirometry.
Correct Answer : B,C,D
Choice A rationale
While pain management is crucial postoperatively, teaching the client how to use a PCA pump does not directly prevent common postoperative complications like pneumonia, deep vein thrombosis, or wound infections. These complications are more directly addressed by respiratory exercises and early mobilization.
Choice B rationale
Instructing the client on coughing and deep breathing exercises is essential for preventing postoperative pulmonary complications such as atelectasis and pneumonia. These exercises help to expand the lungs, mobilize secretions, and improve oxygenation, reducing the risk of infection and respiratory distress.
Choice C rationale
Explaining the importance of early ambulation is vital in preventing several postoperative complications. Mobilization improves circulation, reducing the risk of deep vein thrombosis and pulmonary embolism. It also helps to promote bowel function and prevent constipation, as well as aiding in lung expansion and preventing atelectasis.
Choice D rationale
Discussing the use of incentive spirometry is important for preventing postoperative respiratory complications. Incentive spirometry encourages deep and sustained inhalation, which helps to expand the alveoli, improve lung volume, and prevent atelectasis and pneumonia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Pruritus following scabies treatment is often due to residual irritation from the mites and the inflammatory response. Mittens can prevent scratching, which can exacerbate the itching, lead to skin breakdown, and increase the risk of secondary infections.
Choice B rationale
Rubbing the affected area, even gently, can further irritate the skin and intensify the itching sensation. This can prolong discomfort and potentially cause skin damage.
Choice C rationale
Applying additional scabicide after the prescribed treatment is completed is generally not recommended and can cause skin irritation or even systemic toxicity if overused. Pruritus after treatment is usually due to the body's reaction to dead mites and their products, not ongoing infestation.
Choice D rationale
Hot showers can dry out the skin and worsen pruritus. Warm or cool showers are generally recommended for individuals experiencing itching, as they are less likely to cause further irritation.
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale
A client who is ambulatory following a cardiac catheterization 4 hours ago has increased mobility, which reduces the risk of prolonged pressure on bony prominences. The short duration post-procedure and ability to ambulate make this client less susceptible to pressure ulcer development.
Choice B rationale
Postoperative delirium can lead to decreased mobility, increased agitation and friction against surfaces, and impaired ability to communicate discomfort or reposition themselves. These factors significantly increase the risk of prolonged pressure and subsequent pressure ulcer formation.
Choice C rationale
Protein-calorie malnutrition results in decreased subcutaneous tissue and muscle mass, which normally provide cushioning over bony prominences. Poor nutritional status also impairs tissue repair and increases skin fragility, making the client highly susceptible to pressure ulcer development.
Choice D rationale
Right-sided heart failure can cause fluid overload and peripheral edema, particularly in the lower extremities. This edema increases tissue fragility and reduces blood flow to the skin, making it more susceptible to breakdown and pressure ulcer formation, especially in areas with bony prominences like heels and ankles.
Choice E rationale
While hyperglycemia in type 1 diabetes mellitus can impair wound healing and increase the risk of infection if a pressure ulcer develops, it is not a direct primary risk factor for the initial development of pressure ulcers. Immobility, malnutrition, and edema are more direct contributors to skin breakdown due to pressure.
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