A nurse is reinforcing teaching with a client who reports right shoulder pain following a laparoscopic cholecystectomy. Which of the following statements should the nurse make?

"The pain occurs as a residual pain from cholecystitis."

"The pain results from lying in one position too long during surgery."

"The pain is caused from the nitrous dioxide injected into the abdomen."

"The pain will dissipate if you ambulate frequently."

Answer and Explanation

The Correct Answer is D

A.   Postoperative pain typically resolves after a laparoscopic cholecystectomy since the surgery removes the gallbladder
B.   While positioning during surgery can cause discomfort, isolated right shoulder pain is more commonly attributed to the diaphragmatic irritation from residual nitrous oxide in the abdomen.

C.   Nitrous dioxide used during laparoscopic procedures is not associated with referred pain to the right shoulder. The pain is due to carbon dioxide gas used during the procedure resulting in the irritation of the diaphragm.
D.   This pain is often due to the carbon dioxide used to inflate the abdomen during surgery, which can irritate the diaphragm and refer pain to the shoulder. Ambulation helps to absorb the gas more quickly.

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Correct Answer is D

Explanation

A. Leukemia itself doesn't necessitate contact precautions unless there are other specific infectious concerns, which are not mentioned in this scenario.
B. Ibuprofen is contraindicated in patients with low platelet counts due to the risk of bleeding. Therefore, administering ibuprofen would exacerbate the risk of bleeding in this patient.
C. Invasive procedures like rectal temperature measurements should be avoided in patients with low platelet counts due to the risk of bleeding. Thus, this intervention increases the risk of harm to the patient.
D. Patients with low platelet counts are at risk for bleeding, including gastrointestinal bleeding. Administering a stool softener can help prevent straining during bowel movements, reducing the risk of bleeding and promoting patient comfort and safety.

A. signs of polycythemia B. Need for fluid restrictions C. Obtain a daily weight D. Frequent oral care E. Normal protein in the diet F. Avoid nephrotoxic substances G. Decrease sodium in the diet H. Close monitoring of urine output

Correct Answer is ["B","C","D","E","G","H"]

Explanation

A. Polycythemia (an abnormally high red blood cell count) is not typically a primary concern in dialysis patients; instead, they are more often monitored for anemia.
B. Dialysis patients often need to restrict fluid intake to prevent fluid overload, which can exacerbate edema and cause additional cardiovascular strain.
C. Daily weight monitoring is crucial for dialysis patients to track fluid balance and detect any sudden changes that might indicate fluid retention or loss.
D. Frequent oral care is important to prevent infections, particularly because dialysis patients are at increased risk due to their compromised immune systems and possible fluid restrictions, which can lead to dry mouth and other oral health issues.
E. Dialysis patients may need a modified protein intake, depending on their specific needs and the type of dialysis (hemodialysis vs. peritoneal dialysis). Protein needs can vary, so it is essential to follow the specific dietary recommendations provided by a healthcare provider.
F. Avoiding nephrotoxic substances (e.g., certain medications, contrast dyes) is critical to protect the remaining kidney function and prevent further damage.
G. A low-sodium diet helps manage blood pressure and fluid balance, reducing the risk of fluid retention and hypertension in dialysis patients.

H. Monitoring urine output is important to assess kidney function and fluid balance.

Even though dialysis takes over some kidney functions, any remaining urine output can provide valuable information about the patient's residual kidney function.

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A nurse is reinforcing teaching with a client who reports right shoulder pain following a laparoscopic cholecystectomy. Which of the following statements should the nurse make?

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A nurse is assisting with the plan of care for a client who has leukemia and whose platelet count is 50,000 mm. Which of the following interventions should the nurse include in the plan of care?

Correct Answer is D

Explanation

The nurse is caring for a 32-year-old female patient coming to the clinic with peripheral edema, periorbital edema, and flank pain. Use the chart to answer the questions. Exhibits Which items should the nurse include when teaching the patient and family about dialysis? Select all that apply.

Correct Answer is ["B","C","D","E","G","H"]

Explanation

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