A nurse is providing preoperative teaching to a client who is scheduled for a radical prostatectomy. Which of the following information should the nurse include in the teaching?

The client will be on bed rest while continuous bladder irrigation is in place.

Cold compresses will be used to manage bladder spasms.

The client will have an NG tube in place for 48 hr postoperatively.

A PCA pump will be used for postoperative pain control.

Answer and Explanation

The Correct Answer is D

Rationale:
A. The client will be on bed rest while continuous bladder irrigation is in place.: Bed rest is not required solely due to continuous bladder irrigation (CBI). Early ambulation is encouraged postoperatively to prevent complications such as deep vein thrombosis and promote recovery.

B. Cold compresses will be used to manage bladder spasms.: Bladder spasms are common after prostate surgery, but they are typically managed with anticholinergic medications, such as oxybutynin, rather than cold compresses.

C. The client will have an NG tube in place for 48 hr postoperatively.: An NG tube is not routinely used following a radical prostatectomy unless the client develops complications like ileus or vomiting. Its use is not part of standard postoperative care.

D. A PCA pump will be used for postoperative pain control.: A patient-controlled analgesia (PCA) pump is commonly used after major surgeries like a radical prostatectomy to manage pain effectively. It allows the client to self-administer controlled doses of pain medication for optimal comfort.

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Correct Answer is B

Explanation

Rationale:
A. Continuous passive motion device: This device is typically used following total knee arthroplasty to maintain joint mobility and prevent stiffness. It is not commonly indicated after total hip arthroplasty, where excessive hip movement is discouraged during early recovery.

B. Elevated toilet seat: An elevated toilet seat helps prevent excessive hip flexion, which reduces the risk of hip dislocation after surgery. It allows the client to sit and stand more safely without bending the hip beyond 90 degrees, which is a critical precaution following hip arthroplasty.

C. Trapeze bar: A trapeze bar may assist some clients in repositioning while in bed, but it is not a standard discharge requirement for hip arthroplasty. Its use is more common in inpatient rehabilitation or in clients with prolonged immobility.

D. Compression garment: While compression stockings may be used to reduce the risk of deep vein thrombosis (DVT), a compression garment is not a standard or essential piece of home equipment following hip replacement surgery unless specifically indicated by the healthcare provider.

A. Distended neck veins B. Rapid pulse rate C. Urine output 45 mL/hr D. Decreased respiratory rate

Correct Answer is B

Explanation

Rationale:
A. Distended neck veins: Distended neck veins are typically associated with fluid volume excess, such as in heart failure or hypervolemia. In hypovolemia, the central venous pressure is low, often resulting in flat or collapsed neck veins due to the decreased circulating blood volume and reduced venous return.

B. Rapid pulse rate: Tachycardia is a key early sign of hypovolemia, as the heart attempts to compensate for decreased blood volume by increasing the heart rate to maintain adequate cardiac output. This compensatory mechanism helps preserve perfusion to vital organs during volume loss.

C. Urine output 45 mL/hr: A urine output of 45 mL/hr is considered adequate and within the normal range for an adult. In hypovolemia, renal perfusion typically decreases, often leading to oliguria (urine output less than 30 mL/hr), which would be a more specific indicator of fluid deficit.

D. Decreased respiratory rate: Hypovolemia generally triggers an increase in respiratory rate (tachypnea) as a compensatory response to improve oxygen delivery and perfusion. A decreased respiratory rate would be unusual and not characteristic of a volume-depleted state.

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A nurse is providing preoperative teaching to a client who is scheduled for a radical prostatectomy. Which of the following information should the nurse include in the teaching?

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