A6-week-old infant with pyloric stenosis is scheduled for a pyloromyotomy, Which pre- operative nursing action has highest priority?

Mark an outline of the "olive-shaped mass in the right epigastric area

Initiate a continuous infusion of IV Fluids per prescription.

Monitor amount of intake and infant's response to feedings.

Instruct parents regarding care of the incisional area.

Answer and Explanation

The Correct Answer is B

A. Marking an outline of the "olive-shaped mass" in the right epigastric area is important for diagnosis, but not a priority pre-operatively.
B. Initiating a continuous infusion of IV fluids is crucial to ensure the infant is properly hydrated before the procedure, as pyloric stenosis can cause severe dehydration.
C. Monitoring the amount of intake and the infant's response to feedings is part of ongoing care, but immediate pre-operative hydration takes precedence.
D. Instructing parents regarding care of the incisional area is necessary post-operatively, not before the surgery.

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Correct Answer is ["B","C"]

Explanation

A. Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID commonly used for
pain relief and inflammation. However, it may not be suitable for this patient due to the potential risk of bleeding and interference with wound healing after surgery.
B. Docusate sodium: Docusate sodium is a stool softener commonly prescribed with opioids to prevent constipation, a common side effect of opioid use. It helps to prevent or alleviate opioid- induced constipation.
C. Naloxone: Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. It is typically prescribed alongside opioids as a precautionary measure to counteract the respiratory
depression and sedation that can occur with opioid use. Administering naloxone can rapidly reverse these effects and restore normal breathing if opioid overdose is suspected.

D. Propofol: Propofol is a sedative-hypnotic medication used for anesthesia induction and
maintenance during surgical procedures. It is not typically prescribed for pain management after surgery.
E. Methadone: Methadone is an opioid agonist often used for managing chronic pain and opioid dependence. While it is an option for pain management, it may not be the first choice for acute post-operative pain relief.
F. SennA Senna is a stimulant laxative used to treat constipation. While constipation is a concern with opioid use, docusate sodium is more commonly prescribed initially for its stool softening effects

A. Obtain postoperative vital signs for a client one day following unilateral knee arthroplasty B. Perform daily surgical dressing change for a client who had an abdominal hysterectomy C. Initiate patient controlled analgesia (PCA pumps for two clients immediately postoperatively. D. Start the second blood transfusion for a client twelve hours following a below knee amputation E. Administer a dose of insulin per sliding scale for a client with type 2 diabetes mellitus (DM)

Correct Answer is ["A","B","E"]

Explanation

A. Obtain postoperative vital signs for a client one day following unilateral knee arthroplasty. Rationale: This task is within the scope of practice for a practical nurse, who can monitor and report changes in a patient's vital signs postoperatively.

B. Perform daily surgical dressing change for a client who had an abdominal hysterectomy.
Rationale: A practical nurse is trained to perform dressing changes, which is a routine postoperative care task.
C. Initiate patient controlled analgesia (PCA pumps for two clients immediately
postoperatively. Rationale: This task is typically reserved for registered nurses as it requires assessment and specialized knowledge in pain management.
D. Start the second blood transfusion for a client twelve hours following a below knee amputation. Rationale: Initiating blood transfusions is generally the responsibility of a registered nurse due to the complexity and potential complications involved.
E. Administer a dose of insulin per sliding scale for a client with type 2 diabetes mellitus (DM). Rationale: A practical nurse can administer medications, including insulin, as per the sliding scale protocol under the supervision of a registered nurse.

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A6-week-old infant with pyloric stenosis is scheduled for a pyloromyotomy, Which pre- operative nursing action has highest priority?

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Correct Answer is ["B","C"]

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