A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching?
Resume sexual intercourse in 2 to 3 weeks.
Increased vaginal drainage typically occurs 5 days following surgery.
Artificial lubrication can be used to treat vaginal itching and dryness.
A Papanicolaou (Pap) test should be performed every 6 months.
The Correct Answer is C
Choice A reason:
Resuming sexual intercourse in 2 to 3 weeks may not be appropriate for all patients after such a major surgery. The recovery time can vary based on individual factors, including the extent of the surgery and the patient's overall health. It's essential for patients to follow their healthcare provider's specific recommendations, which typically involve waiting until after the postoperative check-up, usually around 6 weeks, to ensure proper healing.
Choice B reason:
Increased vaginal drainage typically occurring 5 days following surgery could be a sign of infection or other complications. Normal postoperative discharge should gradually decrease over time. If a patient experiences increased drainage, especially if it's foul-smelling or accompanied by fever, they should contact their healthcare provider immediately.
Choice C reason:
After a total abdominal hysterectomy and bilateral salpingo-oophorectomy, patients may experience vaginal dryness due to decreased estrogen levels. Using artificial lubricants can help alleviate symptoms of itching and dryness, making this an appropriate instruction for postoperative care.
Choice D reason:
A Papanicolaou (Pap) test is not typically required every 6 months after a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer unless the surgery was performed as treatment for cervical cancer or serious pre-cancer. For those who had the procedure due to benign conditions, further Pap tests are generally not necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
A reddened area over the sacrum is a sign of potential pressure ulcer development, which is a common complication of immobility, especially in bedridden or wheelchair-bound individuals. The sacrum is a prominent bony area that bears weight when a person is sitting or lying down, making it susceptible to pressure ulcers if proper preventative measures, such as regular repositioning, are not taken.
Choice B reason:
Difficulty hearing some types of sounds is not typically a direct complication of immobility. Hearing issues may be related to other health conditions or age-related changes but are not caused by the lack of movement associated with post-stroke immobility.
Choice C reason:
Stiffness in the lower extremities can occur due to immobility, as muscles and joints may become tight when not used regularly. However, this is more of a long-term effect and may not be as immediately concerning as pressure ulcer prevention. Regular range-of-motion exercises can help prevent stiffness.
Choice D reason:
Difficulty moving the upper extremities may be a result of the stroke itself rather than a complication of immobility. While maintaining mobility in all limbs is important, the focus of monitoring should be on complications that arise specifically due to immobility, such as pressure ulcers.
Correct Answer is D
Explanation
Choice A reason: Positive Trousseau's sign
Trousseau's sign is indicative of hypocalcemia, not CTS. It is elicited by inflating a blood pressure cuff on the upper arm to above systolic pressure for 3 minutes. A positive sign is characterized by carpal spasm, which is not related to CTS.
Choice B reason: Cool extremities
Cool extremities can be a result of various conditions, including peripheral vascular disease or hypothyroidism. They are not a specific indicator of CTS, which primarily affects nerve function rather than blood circulation or temperature regulation.
Choice C reason: Decreased radial pulse
A decreased radial pulse is not typically associated with CTS. It may indicate a cardiovascular issue or a blockage in the radial artery, which would require further investigation unrelated to CTS.
Choice D reason: Positive Phalen's sign
Phalen's sign is a diagnostic test for CTS. The test is performed by having the patient flex their wrist maximally and hold the position for about 60 seconds. A positive Phalen's sign, which includes numbness and tingling in the thumb, index finger, middle finger, and the radial half of the ring finger, is indicative of CTS. This occurs due to increased pressure on the median nerve when the wrist is in flexion.
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