After having a vertical sleeve gastrectomy performed, a 42-year-old male client returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a client-controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the post-op plan of care for the first 24 hours?
Teach the client to support the surgical site while deep breathing and coughing
Teach that PCA use may slow the return of bowel function, so the client should not overuse it
Irrigate and reposition the NGT frequently
Offer cups of fruit juices at frequent intervals
The Correct Answer is A
A. Teach the client to support the surgical site while deep breathing and coughing: This action is appropriate as it helps prevent complications such as atelectasis and pneumonia by promoting lung expansion and clearing secretions. Supporting the surgical site while deep breathing and coughing helps reduce pain and discomfort during these activities.
B. This is an important teaching point for clients using PCA for pain control after surgery. Opioid medications used in PCA can lead to gastrointestinal motility issues, including constipation. However, pain management is central within the first 24 hours post operation.
C. Irrigating and repositioning the NGT frequently can increase the risk of complications such as displacement or irritation of the surgical site. NGT care should be performed as needed based on institutional protocols and the client's condition.
D. The client's diet will likely be advanced gradually, starting with clear fluids and progressing to full liquids and then solid foods as tolerated. Fruit juices may be introduced gradually as part of the liquid diet once the client's gastrointestinal function has recovered sufficiently.
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Related Questions
Correct Answer is C
Explanation
C. Chest pain is a common symptom of esophageal ulcers. The chest pain associated with esophageal ulcers can vary in intensity and may be described as burning, gnawing, or sharp. The pain may worsen with swallowing and may be relieved by antacids or other medications that reduce stomach acid.
A. Lower abdominal pain is not a common symptom of esophageal ulcers. Esophageal ulcers typically present with symptoms localized to the chest and upper abdomen, such as chest pain or epigastric discomfort.
B. Joint stiffness is not typically associated with esophageal ulcers. Joint stiffness may occur in conditions such as arthritis but is not a characteristic symptom of esophageal ulcers.
D. Frequent urination is not typically associated with esophageal ulcers. This symptom may be indicative of urinary tract infections, diabetes, or other urinary system disorders but is not directly related to esophageal ulcers.
Correct Answer is D
Explanation
D. Bloody diarrhea is a hallmark symptom of ulcerative colitis, particularly during disease flares. It typically presents as frequent and urgent bowel movements containing blood, mucus, and pus. Crohn's disease, on the other hand, may present with bloody diarrhea but usually involves less frequent bowel movements.
A. Both ulcerative colitis and Crohn's disease can manifest at various ages, including during adolescence and early adulthood.
B. Abdominal pain and cramping are common symptoms of both ulcerative colitis and Crohn's disease.
C. Weight loss can occur in both ulcerative colitis and Crohn's disease due to factors such as decreased appetite, malabsorption, and inflammation of the gastrointestinal tract.
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