An older adult who is on bed rest after surgery is prescribed morphine for pain. Which of the following is the nurse's priority for preventive care?
Constipation
Poor solid food intake
Poor liquid intake
Diarrhea
The Correct Answer is A
A. Constipation.
Explanation: Constipation is a common side effect of opioid medications like morphine. Older adults, particularly those on bed rest or with reduced mobility, are already at an increased risk of constipation. Morphine further contributes to this risk by slowing down bowel motility. Preventive measures such as promoting adequate hydration, encouraging fiber intake, and considering stool softeners can help prevent constipation in this scenario.
B. Poor solid food intake.
Explanation: While monitoring and addressing poor solid food intake are important for overall nutritional status, it may not be the immediate priority related to morphine use and postoperative care.
C. Poor liquid intake.
Explanation: Ensuring adequate fluid intake is important for overall hydration, but constipation is a more specific and immediate concern associated with opioid use.
D. Diarrhea.
Explanation: Diarrhea is not a common side effect of morphine and is less likely to be the priority for preventive care in this situation. Constipation is a more anticipated concern when opioids are prescribed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E","F"]
Explanation
A. Stroke under the chin in a downward motion.
Explanation: Stroking under the chin in a downward motion is not considered a standard technique for managing dysphagia. It's important to focus on strategies that promote safe swallowing and prevent aspiration.
B. Keep pulse oximeter ready at all times.
Explanation: While monitoring oxygen saturation is important in certain situations, having a pulse oximeter ready at all times may not be a routine instruction for feeding a client with dysphagia. Monitoring for signs of distress and ensuring a safe feeding environment are key aspects of care.
C. Avoid rushing the client or force feeding her.
Explanation: Rushing or force-feeding a client with dysphagia can increase the risk of aspiration. It's important to allow the client to eat at their own pace and take adequate time to chew and swallow safely.
D. If facial weakness is present, place food on the impaired side of the mouth.
Explanation: Placing food on the impaired side of the mouth can help compensate for facial weakness and promote more effective chewing and swallowing.
E. Alternate solid and liquid boluses.
Explanation: Alternating solid and liquid boluses can help with the overall coordination of the swallowing process. It can also facilitate the movement of food and liquids through the digestive tract.
F. Have the client sit at 90 degrees during all of oral intake.
Explanation: Ensuring that the client sits at a 90-degree angle during oral intake helps promote an upright position that aids in swallowing and reduces the risk of aspiration.
Correct Answer is ["A","B","C","D"]
Explanation
A. Making refreshment stations readily available
Explanation: Making refreshment stations readily available can encourage individuals with dementia to access snacks and beverages independently. This can help ensure a consistent intake of calories and nutrients throughout the day.
B. Caloric supplements with the meals
Explanation: Caloric supplements can provide additional nutrients and energy, especially if the client has difficulty consuming an adequate amount of food during meals. Consultation with a healthcare professional is recommended to determine the appropriate type and amount of supplements.
C. Providing feeding assistance
Explanation: Offering feeding assistance, such as help with cutting food into manageable pieces or providing cueing and encouragement during meals, can support individuals with dementia in maintaining proper nutrition.
D. Optimal social supports
Explanation: Optimal social supports, including family members, caregivers, or support groups, can play a crucial role in monitoring the nutritional status of individuals with dementia. Social interactions during meals can positively impact eating behaviors, and caregivers can provide assistance and encouragement.
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