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
Encouraging the patient to write down questions promotes active engagement in their care and ensures that all their concerns are addressed during the consultation with the provider. This empowers the patient to seek clarification and understand the proposed plan of care directly from the healthcare professional responsible for it.
Choice B rationale
Providing internet articles about colon cancer stages can overwhelm the newly diagnosed patient with potentially complex and sometimes unreliable information. The specifics of the patient's diagnosis and treatment plan should come directly from their healthcare provider, who can tailor the information to their individual situation and answer specific questions.
Choice C rationale
While it is true that the provider will explain the planned treatment, this response does not actively address the patient's immediate need for information and may make the patient feel dismissed. Encouraging the patient to prepare questions ensures a more productive and informative discussion with the provider.
Choice D rationale
Explaining treatment options based on cancer stage is the responsibility of the healthcare provider, who has the complete clinical picture and can discuss the risks, benefits, and potential outcomes of each option in the context of the patient's specific case. The nurse's role at this stage is to facilitate communication between the patient and the provider, not to provide detailed medical explanations.
Correct Answer is B
Explanation
Choice A rationale
Weight loss can occur at various stages of rheumatoid arthritis due to chronic inflammation and increased metabolic demands. While it can be present later in the disease, it is not specifically identified as a late manifestation. Systemic inflammation leads to the release of pro-inflammatory cytokines, which can affect appetite and metabolism, contributing to weight changes throughout the course of the disease.
Choice B rationale
Knuckle deformities, such as swan neck and boutonniere deformities, are characteristic late manifestations of rheumatoid arthritis. These deformities result from chronic inflammation and synovial proliferation leading to damage of the tendons, ligaments, and joint capsule around the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. Over time, this causes the characteristic changes in finger alignment.
Choice C rationale
Low-grade fever can be a systemic manifestation of the inflammatory process in rheumatoid arthritis, but it is more commonly seen during active flares and is not specifically classified as a late manifestation. The fever is a result of the release of pyrogens, such as interleukin-1 and tumor necrosis factor-alpha, during periods of heightened immune activity. Normal body temperature ranges from 97.8°F to 99.1°F (36.5°C to 37.3°C).
Choice D rationale
Anorexia, or loss of appetite, can be associated with the chronic pain and systemic inflammation of rheumatoid arthritis at any stage. Inflammatory cytokines can affect appetite regulation in the hypothalamus. While it might persist in later stages, it is not a definitive late manifestation compared to structural joint changes.
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