A nurse is teaching a client who has peptic ulcer disease and is scheduled for an esophagogastroduodenoscopy the next morning. Which following information should the nurse include in the teaching?

"You will be allowed to drive yourself home within 6 hours following the procedure."

"You might experience a hoarse voice for several days following the procedure."

"You can have a clear liquid diet for breakfast prior to the procedure."

"You should not take any of your routine medications until after the procedure is complete."

Answer and Explanation

The Correct Answer is B

A) "You will be allowed to drive yourself home within 6 hours following the procedure."This statement is incorrect. After an esophagogastroduodenoscopy (EGD), the patient is typically sedated, and the sedation can affect their alertness, coordination, and judgment. It is generally recommended that patients arrange for someone else to drive them home. It is unsafe for the patient to drive themselves after sedation, even if they feel alert. The nurse should instruct the client to have someone accompany them to the procedure and drive them home afterward.

B) "You might experience a hoarse voice for several days following the procedure."This statement is correct. A hoarse voice is a common and expected side effect after an esophagogastroduodenoscopy, as the procedure involves passing a flexible tube (endoscope) through the mouth and throat. The endoscope may cause irritation to the vocal cords or the lining of the throat, leading to a hoarse voice that can last for a few days. This is a normal, transient effect and should be explained to the patient in advance so they are not alarmed.

C) "You can have a clear liquid diet for breakfast prior to the procedure."This statement is incorrect. For most procedures like EGD, patients are typically instructed to fast for at least 6 to 8 hours prior to the procedure to ensure the stomach is empty. Having food or liquids before the procedure may increase the risk of aspiration or interfere with the examination. The nurse should educate the client to follow fasting instructions and avoid consuming any food or liquids, including clear liquids, as per the healthcare provider's guidelines.

D) "You should not take any of your routine medications until after the procedure is complete."

This statement is generally incorrect. Many patients are instructed to continue taking routine medications, especially if they are vital for managing chronic conditions, unless otherwise directed by the healthcare provider. In some cases, medications such as anticoagulants, aspirin, or certain blood pressure medications may need to be withheld temporarily before the procedure. However, the nurse should clarify with the healthcare provider which medications the client should stop or continue taking before the procedure. The patient should not withhold medications on their own without proper guidance.

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Correct Answer is D

Explanation

A) Contact dermatitis: This condition results from an allergic reaction or irritation caused by contact with a substance, such as chemicals, detergents, or allergens. It is not a communicable skin infection and does not spread from person to person.

B) Actinic keratoses: These are rough, scaly patches on the skin caused by prolonged exposure to ultraviolet (UV) rays. They are considered precancerous lesions and are not contagious. They result from environmental factors rather than person-to-person transmission.

C) Psoriasis: This is a chronic autoimmune condition that leads to the rapid buildup of skin cells, causing scaling on the skin's surface. It is not contagious and does not spread through person-to-person contact. Psoriasis is an inherited condition influenced by immune system triggers.

D) Herpes zoster: Also known as shingles, this condition is caused by the reactivation of the varicella-zoster virus (the same virus that causes chickenpox). While shingles itself is not spread from person to person, the virus can be transmitted from a person with shingles to someone who has never had chickenpox, potentially causing chickenpox in the latter individual. The virus is spread through direct contact with the fluid from the blisters.

A. Double-bag the client's trash before removing it from the room. B. Place the client in a negative air pressure room with 6 to 12 air exchanges per hour. C. Ensure all air in the client's room is filtered through a HEPA filter. D. Wear a surgical mask when within 1 m (3 ft) of the client.

Correct Answer is D

Explanation

A) Double-bag the client's trash before removing it from the room: Double-bagging trash is typically recommended for patients with highly contagious and severe infectious diseases, such as those requiring contact precautions. Influenza, while contagious, does not necessitate this level of precaution.

B) Place the client in a negative air pressure room with 6 to 12 air exchanges per hour: Negative air pressure rooms are used for airborne diseases like tuberculosis or measles, which can spread through the air over long distances. Influenza primarily spreads through respiratory droplets, so this precaution is not necessary.

C) Ensure all air in the client's room is filtered through a HEPA filter: HEPA filters are used for airborne pathogens to filter out infectious particles. Since influenza spreads via respiratory droplets rather than airborne particles, this level of air filtration is not required.

D) Wear a surgical mask when within 1 m (3 ft) of the client: Influenza spreads through respiratory droplets, which can travel up to about 1 meter (3 feet) when a person coughs or sneezes. Wearing a surgical mask within this distance helps prevent inhalation of these droplets, making it the appropriate precaution for influenza.

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