The circulating nurse notes in the nutritional assessment of the client who is scheduled for total hip replacement surgery that the client is 20 lbs (9.07 kg) underweight for their height. The nurse should:

Weigh the patient prior to the procedure.

Use extra padding on bony prominences.

Use extra safety straps.

Notify the surgeon.

Answer and Explanation

The Correct Answer is D

Choice A reason: Weighing the patient prior to the procedure is a standard practice and ensures accurate dosing of medications and anesthesia. However, it does not address the immediate concern of the patient being underweight, which could impact their surgical and recovery outcomes.

Choice B reason: Using extra padding on bony prominences is important for preventing pressure ulcers, especially in underweight patients who have less natural padding. While this is a necessary precaution, it does not directly address the underlying issue of the patient’s nutritional status.

Choice C reason: Using extra safety straps can help secure the patient during surgery, but it does not address the nutritional concerns that could affect the patient’s recovery and overall health.

Choice D reason: Notifying the surgeon is crucial because the patient’s underweight status could significantly impact their surgical risk and recovery. The surgeon needs to be aware of this to make any necessary adjustments to the surgical plan or to involve a nutritionist or other specialists to address the patient’s nutritional needs before and after surgery.

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

Explanation

Choice A reason:

Avoiding crowds during the cold and flu season is crucial for a client recovering from pneumonia. Pneumonia weakens the lungs and the immune system, making the client more susceptible to infections. Crowded places increase the risk of exposure to respiratory infections, which can complicate recovery. According to UpToDate, patients with pneumonia should avoid exposure to infectious agents to prevent further complications.

Choice B reason:

Increasing activities to the previous level as soon as you get home is not advisable. Clients recovering from pneumonia need to gradually return to their normal activities. Overexertion can lead to fatigue and delay recovery. The Mount Sinai Health Library advises patients to rest and gradually increase activity levels as they regain strength.

Choice C reason:

Reporting temperature elevations to the healthcare provider is essential. Fever can be a sign of an ongoing infection or a complication. Normal body temperature ranges from 97°F to 99°F (36.1°C to 37.2°C). Any elevation above this range should be reported to ensure timely intervention.

Choice D reason:

Finishing taking oral antibiotics as prescribed is critical to ensure the infection is fully treated and to prevent antibiotic resistance. Incomplete antibiotic courses can lead to a resurgence of the infection and contribute to the development of resistant bacteria.

Choice E reason:

Electronic cigarettes are not a recommended alternative to tobacco while trying to quit. The safety and efficacy of e-cigarettes as a smoking cessation tool are still under investigation. The American Lung Association advises against using e-cigarettes due to potential health risks.

A. pH 7.37, PaO2 90 mmHg, PaCO2 44 mmHg, HCO3 22 mEq/L B. pH 7.36, PaO2 60 mmHg, PaCO2 45 mmHg, HCO3 22 mEq/L C. pH 7.48, PaO2 80 mmHg, PaCO2 32 mmHg, HCO3 18 mEq/L D. pH 7.27, PaO2 70 mmHg, PaCO2 38 mmHg, HCO3 14 mEq/L

Correct Answer is A

Explanation

Choice A reason:

A pH of 7.37, PaO2 of 90 mmHg, PaCO2 of 44 mmHg, and HCO3 of 22 mEq/L indicate a near-normal acid-base balance and adequate oxygenation. The pH is within the normal range (7.35-7.45), suggesting that the client’s acid-base status has improved. The PaO2 is also within the normal range (80-100 mmHg), indicating good oxygenation.

Choice B reason:

A pH of 7.36, PaO2 of 60 mmHg, PaCO2 of 45 mmHg, and HCO3 of 22 mEq/L indicate a slightly acidic pH and hypoxemia (low PaO2). While the pH is close to normal, the low PaO2 suggests that the client is still experiencing significant respiratory distress.

Choice C reason:

A pH of 7.48, PaO2 of 80 mmHg, PaCO2 of 32 mmHg, and HCO3 of 18 mEq/L indicate alkalosis (high pH) and a low PaCO2, which may suggest hyperventilation. This is not an improved acid-base status as it indicates an imbalance.

Choice D reason:

A pH of 7.27, PaO2 of 70 mmHg, PaCO2 of 38 mmHg, and HCO3 of 14 mEq/L indicate acidosis (low pH) and hypoxemia. This result suggests that the client is still in significant respiratory distress and has not achieved an improved acid-base status.

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The circulating nurse notes in the nutritional assessment of the client who is scheduled for total hip replacement surgery that the client is 20 lbs (9.07 kg) underweight for their height. The nurse should:

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