A nurse is reviewing discharge instructions with a client who had a laparoscopic cholecystectomy. Which of the following statements by the client indicates a need for further teaching? (Select all that apply.)

Choice A reason:

Removing dentures, glasses, contact lenses, jewelry and nail polish is part of the physical preparation of the client before surgery. These items can interfere with the anesthesia, cause injury, or be lost during the procedure.

Choice B reason:

Administering a sedative or anxiolytic medication as prescribed is part of the preoperative medication of the client before surgery. These medications can help reduce anxiety, pain, nausea, and vomiting, and facilitate induction of anesthesia.

Choice C reason:

Marking the surgical site with an indelible marker is part of the patient identification and verification process before surgery. This helps prevent wrong-site, wrong-procedure, or wrong-person surgery by ensuring that the correct site is marked and confirmed by the client, surgeon, and nurse.

Choice D reason:

All of the above. All of these items should be completed before transferring the client to the operating room as part of the preoperative checklist. The checklist ensures that necessary documentation, admission assessment, physical preparation, and client education have been completed before the client enters the surgical suite.

Choice A reason:

Shivering is a sign of hypothermia because it is the body's way of generating heat when the core temperature drops below normal. Shivering can be uncontrollable in mild hypothermia and may stop in moderate to severe hypothermia as the body conserves energy.

Choice B reason:

Tachycardia is not a sign of hypothermia. In fact, hypothermia can cause bradycardia, which is a slow heart rate, as the body tries to reduce heat loss through the blood vessels.

Choice C reason:

Pallor is a sign of hypothermia because it indicates reduced blood flow to the skin as the blood vessels constrict to preserve core temperature. Pallor can also be accompanied by cyanosis, which is a bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood.

Choice D reason:

Diaphoresis is a sign of hypothermia because it is the result of excessive sweating that can occur after exposure to cold or wet environments. Sweating can increase heat loss through evaporation and lower the body temperature further.

Choice E reason:

Hypotension is a sign of hypothermia because it reflects decreased cardiac output and blood pressure as the heart muscle becomes less efficient and responsive to stimuli. Hypotension can also lead to shock, organ failure, and death if not treated promptly.