Eight hours postoperative following a total knee replacement, which intervention should the nurse implement for the client?

Apply cool compresses to the affected limb every six hours.

Place a soft pillow under the affected knee.

Promote bedrest for 24 hours.

Encourage increased fluid intake.

Answer and Explanation

The Correct Answer is D

Choice A Reason
Applying cool compresses to the affected limb can help reduce swelling and provide pain relief. However, it's important to follow the surgeon's specific postoperative orders, as the application of cold can vary depending on the surgical technique and patient's condition.

Choice B Reason
Placing a soft pillow under the knee is not recommended after total knee replacement surgery. This position can lead to decreased range of motion and contractures. The knee should be kept in a more extended position to promote healing and mobility.

Choice C Reason
Promoting bedrest for an extended period is not typically advised following knee replacement surgery. Early mobilization is important to prevent complications such as deep vein thrombosis and to encourage circulation and healing. The duration of bedrest should be as per the surgeon's protocol.

Choice D Reason
Encouraging increased fluid intake is important after surgery to prevent dehydration, promote kidney function, and ensure adequate blood volume and circulation. Proper hydration is essential for healing and can help with the metabolism of medications used during and after surgery.

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Correct Answer is D

Explanation

Choice A Reason
Using an antiemetic one hour after administration of methotrexate is not a standard recommendation. Antiemetics are typically used to prevent nausea and vomiting associated with chemotherapy and are taken before or at the time of methotrexate administration, not afterward.

Choice B Reason
Drinking 2-3 liters of water per day is important for patients taking methotrexate to prevent kidney damage by ensuring adequate hydration and facilitating the excretion of the drug¹. Methotrexate can be nephrotoxic, and proper hydration helps to mitigate this risk.

Choice C Reason
Rinsing the mouth with an alcohol-based mouthwash is not recommended for patients taking methotrexate. Alcohol can cause drying and irritation, which might exacerbate any mouth sores caused by methotrexate. Instead, patients should use a gentle, non-alcoholic mouthwash to maintain oral hygiene.

Choice D Reason
Taking methotrexate with an NSAID is not advised without specific medical guidance. NSAIDs can increase the toxicity of methotrexate by displacing it from protein-binding sites and reducing its renal clearance, potentially leading to increased side effects.

A. Check blood glucose levels prior to exercising. B. Signs and symptoms of hypoglycemia. C. Weight control is necessary for this disease. D. Decrease fiber and protein in the diet. E. Obtain eye examinations every 3 months.

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

Explanation

Choice A Reason
Monitoring blood glucose levels before exercise is crucial for individuals with Type 2 diabetes. Exercise can lower blood glucose levels, and it's important to ensure they are not too low before starting, which could lead to hypoglycemia during physical activity. The patient should be taught how to check their glucose and understand their target ranges.

Choice B Reason
Recognizing the signs and symptoms of hypoglycemia is essential for all individuals with diabetes, especially those on medications that can lower blood glucose levels. Symptoms may include shakiness, sweating, confusion, and in severe cases, loss of consciousness. Patients should know how to respond to these symptoms promptly.

Choice C Reason
Weight control through diet and exercise is a fundamental part of managing Type 2 diabetes. A BMI of 28 falls into the overweight category, and reducing weight can help improve insulin sensitivity and blood glucose control. The patient should receive guidance on healthy eating and physical activity tailored to their needs.

Choice D Reason
Decreasing fiber and protein in the diet is not recommended for individuals with Type 2 diabetes. In fact, a diet high in fiber can help control blood sugar levels, and adequate protein intake is important for overall health. Patients should be encouraged to consume a balanced diet with sufficient fiber and protein.

Choice E Reason
While regular eye examinations are important for individuals with diabetes, obtaining them every 3 months is not typically necessary unless there is an existing eye condition that requires close monitoring. Generally, an annual eye exam is recommended to check for diabetes-related eye complications.

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Eight hours postoperative following a total knee replacement, which intervention should the nurse implement for the client?

Nursing Test Bank

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