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

Choice A reason: Yellow discoloration of the skin indicates jaundice, caused by elevated bilirubin due to impaired liver function in cirrhosis. It is a common finding but not caput medusae, which specifically refers to vascular changes around the umbilicus due to portal hypertension, making this incorrect.

Choice B reason: Swollen lymph nodes are not associated with caput medusae. Lymphadenopathy may occur in infections or malignancies but not as a direct result of cirrhosis. Caput medusae involves dilated veins, not lymph nodes, caused by portal hypertension shunting blood to superficial veins.

Choice C reason: Caput medusae is the presence of distended, tortuous veins around the umbilicus, resulting from portal hypertension in cirrhosis. Increased portal vein pressure forces blood into collateral veins, creating a radiating pattern resembling a jellyfish head, making this the accurate description of the finding.

Choice D reason: Dark tarry stools (melena) indicate gastrointestinal bleeding, often from esophageal varices in cirrhosis due to portal hypertension. While a serious finding, it is unrelated to caput medusae, which is a visible vascular phenomenon on the abdomen, not a gastrointestinal symptom.

Choice A reason: Cereal and orange juice are high in simple carbohydrates, causing rapid blood glucose spikes in diabetes. These foods have a high glycemic index, leading to poor glycemic control, making this meal inappropriate for a diabetic diet requiring balanced, low-glycemic foods.

Choice B reason: Salmon, brown rice, and steamed broccoli are ideal for diabetes. Salmon provides omega-3 fatty acids, brown rice offers complex carbohydrates for stable glucose release, and broccoli adds fiber and nutrients, promoting glycemic control and cardiovascular health, making this the best choice.

Choice C reason: Fried chicken, mashed potatoes, and gravy are high in saturated fats and simple carbohydrates. Fried foods and gravy increase insulin resistance and cardiovascular risk, while mashed potatoes can spike blood sugar, making this unsuitable for diabetes management requiring low-fat, low-glycemic meals.

Choice D reason: Pepperoni pizza and soda are high in refined carbohydrates, saturated fats, and sugars. Pizza’s dough and soda’s high sugar content cause rapid glucose spikes, while pepperoni adds unhealthy fats, making this inappropriate for diabetes control, which prioritizes balanced, nutrient-dense foods.