The nurse is aware that in both the very young and the older adult surgical patient, the risk is much higher for:
nausea and vomiting.
delayed healing
anorexia.
hydration issues.
The Correct Answer is B
A. Nausea and vomiting. Nausea and vomiting can occur after surgery due to anesthesia and other factors. However, it is more common in patients of all ages who undergo certain types of surgery. Though these groups may be more susceptible, this is not the most specific risk.
B. Delayed healing. Both very young and older adult patients are at higher risk for delayed healing. In the very young, the immune system and cell regeneration processes are still developing, while in older adults, decreased circulation, chronic conditions, and slower cellular regeneration can impair wound healing.
C. Anorexia. Anorexia is not specific to surgical patients. While appetite loss can occur postoperatively, it is not as universally problematic in young or older surgical patients as delayed healing.
D. Hydration issues. Hydration issues can occur in all patients, especially following surgery, but they are particularly critical for the very young (due to smaller body mass and high fluid turnover) and the elderly (due to decreased kidney function and total body water). However, this is not as universally prevalent as delayed healing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Place a walker at the side of the bed. A walker may not be necessary for all patients and should only be used if prescribed by the healthcare provider.
B. Allow the patient to sit with the head of bed raised to the high Fowler’s position. This helps with postural adjustment but is not the best first step before dangling the legs.
C. Assist the patient to sit and dangle his or her legs on the side of the bed. Gradual movement from lying to sitting to standing helps prevent orthostatic hypotension, which is common after surgery.
D. Assist the patient from a supine position to a standing position. Moving too quickly can cause dizziness, falls, and syncope due to orthostatic hypotension.
Correct Answer is D
Explanation
A. Ask his wife to speak to him to reassure him.
This option is not ideal because the nurse should address the patient's concerns directly. It is important to ensure the patient is making an informed decision and is emotionally supported, but the spouse should not be the first point of contact for reassurance in this case.
B. Assure him that everything will go well.
While it is important to reassure the patient, the nurse should not make promises about the outcome. Assuring the patient everything will go well could lead to unrealistic expectations and may not address the underlying concern.
C. Tear up the surgical consent he signed.
Tearing up the consent is not an appropriate action. The nurse should not act on the patient's uncertainty before consulting the surgeon. The patient has the right to withdraw consent, and this should be addressed properly through communication with the surgeon.
D. Notify the surgeon right away of the situation.
The nurse should immediately notify the surgeon about the patient's change of mind. The surgeon is responsible for providing further clarification and addressing any concerns before proceeding with surgery. The patient must be fully informed and comfortable with their decision.
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