After vertical banded gastroplasty, 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 postoperative plan of care?
Offer cups of fruit juices at frequent intervals.
Irrigate and reposition the NGT frequently.
Remind the client that PCA use may slow the return of bowel function.
Have the client splint the surgical site while deep breathing and coughing.
The Correct Answer is D
Choice A rationale
Offering cups of fruit juices at frequent intervals is not recommended immediately postoperatively due to the risk of nausea and vomiting. The client should start with clear liquids and gradually progress.
Choice B rationale
Irrigating and repositioning the nasogastric tube frequently is not recommended as it can cause discomfort and dislodge the tube. Proper fixation and periodic checking are preferred.
Choice C rationale
Reminding the client that PCA use may slow the return of bowel function is not accurate. While opioids can slow bowel motility, PCA use is for pain management and should be monitored, not discouraged.
Choice D rationale
Having the client splint the surgical site while deep breathing and coughing helps prevent atelectasis and promotes lung expansion. It also reduces pain and protects the surgical incision during respiratory exercises. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Crohn's disease is a chronic inflammatory condition that can affect any part of the gastrointestinal tract from mouth to anus. Surgery cannot cure the disease because inflammation and symptoms can recur in other parts of the digestive system, even after the diseased portion is removed.
Choice B rationale
While colonoscopic procedures can help manage and monitor Crohn's disease, they do not cure it. The disease's chronic nature means that continuous treatment and monitoring are necessary.
Choice C rationale
Surgery can help manage severe cases of Crohn's disease and remove affected portions, but it does not cure the disease. There are risks and complications associated with surgery, and the disease can recur in other areas of the gastrointestinal tract.
Choice D rationale
This statement is inaccurate because it suggests a potential cure through surgery, which is misleading. The chronic and recurrent nature of Crohn's disease means that even after surgical intervention, ongoing management and treatment are required.
Correct Answer is B
Explanation
Choice A rationale
The 19-year-old Native American male hospitalized with a shoulder injury is less likely to develop gallstones. While there is a higher prevalence of gallstones among Native American populations, the risk is not significantly elevated in a young male with no other contributing factors such as obesity, rapid weight loss, or prolonged immobility.
Choice B rationale
The 40-year-old Caucasian pregnant woman who has been on bedrest for the past three months is at a high risk for developing gallstones. Pregnancy increases the risk due to hormonal changes that slow down the emptying of the gallbladder. Prolonged bed rest can lead to bile stasis, and the increased levels of estrogen can raise cholesterol levels in bile, both contributing to gallstone formation.
Choice C rationale
The 64-year-old African-American woman being treated for GERD is at a moderate risk for gallstones. Age and gender are risk factors for gallstones, but without other significant contributing factors such as obesity, rapid weight loss, or specific family history, her risk is not as high as the pregnant woman on bed rest.
Choice D rationale
The 25-year-old Asian woman who has been losing weight steadily for the past year is also at risk for gallstones, but the risk is less compared to the pregnant woman on bed rest. Rapid weight loss can cause gallstones due to the liver secreting extra cholesterol into bile, but steady weight loss over a longer period is less likely to cause such rapid changes in bile composition. .
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