A nurse is ready to insert an indwelling urinary catheter for a female client. Which of the following instructions should the nurse provide to the client as the catheter is inserted?
Bear down.
Exhale slowly.
Contract the pelvic muscles.
Take a sip of water.
The Correct Answer is A
Correct answer: A
A. Bear down:
Bear down: Asking the client to bear down gently (as if to void) helps to expose urethral meatus.Bearing down simulates the act of urination and helps open the urethra.
B. Exhale slowly:
While exhaling slowly might help the client relax, it does not specifically assist with the insertion of the catheter as effectively as bearing down.
C. Contract the pelvic muscles:
Contracting the pelvic muscles (such as squeezing or tightening) might make catheter insertion more challenging by tensing the area where the catheter needs to pass through.
D. Take a sip of water:
Drinking water is not typically instructed during urinary catheter insertion, as it's unrelated to the process and might increase discomfort.
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Related Questions
Correct Answer is B
Explanation
A. Level of consciousness:
While assessing the client's level of consciousness is important, it is not the top priority after an EGD procedure unless there are specific signs of neurological distress. Monitoring for signs of sedation or anesthesia recovery is typically part of post-procedure care.
B. Gag reflex:
This is the correct answer. The nurse should prioritize assessing the gag reflex, as the procedure involves passing a flexible tube through the mouth and down the esophagus. Ensuring the return of the gag reflex is essential to prevent aspiration and ensure the client's safety.
C. Pain:
Pain assessment is important, but it is usually addressed after confirming airway protection and ensuring the absence of complications such as bleeding or perforation.
D. Nausea:
While nausea is a possible post-procedure symptom, assessing the gag reflex and monitoring for signs of complications take precedence over managing nausea in the immediate post-procedure period.
Correct Answer is D
Explanation
A. COPD (Chronic Obstructive Pulmonary Disease) is not directly associated with acute pancreatitis. The common risk factors for acute pancreatitis include gallstones, alcohol use, and certain medications.
B. Hypolipidemia (low blood lipid levels) is not a typical factor associated with acute pancreatitis. Elevated levels of lipids in the blood (hyperlipidemia) can be a risk factor, but hypolipidemia is not commonly linked to pancreatitis.
C. Diabetes mellitus, while not a direct cause of acute pancreatitis, can be associated with an increased risk. Uncontrolled diabetes may contribute to the development of pancreatitis, but it is not a primary risk factor.
D. Gallstones are a significant risk factor for acute pancreatitis. Gallstones can obstruct the pancreatic duct, leading to inflammation and damage to the pancreas. This obstruction is one of the common causes of acute pancreatitis.
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