The nurse is caring for an older adult client who is admitted to the surgical unit following a partial gastrectomy. In addition to frequent position changes, which postoperative intervention is most beneficial for the nurse to perform in preventing respiratory complications?

Promote full diaphragmatic excursion by massaging the back.

Note areas of atelectasis on the daily chest x-rays.

Assist to a chair the day after surgery when the condition is stable.

Provide ice or oral liquids when the client passes flatus.

Answer and Explanation

The Correct Answer is A

A.   Promoting full diaphragmatic excursion by massaging the back helps to facilitate deep breathing and lung expansion, which is essential for preventing respiratory complications such as atelectasis and pneumonia after surgery.
B.   Noting areas of atelectasis on daily chest x-rays is important for assessing respiratory status, but it is a monitoring intervention rather than a preventive intervention.
C.   Assisting the client to a chair the day after surgery when the condition is stable promotes early mobility and prevents complications such as deep vein thrombosis, but it may not directly
address respiratory complications.
D.   Providing ice or oral liquids when the client passes flatus may be part of the postoperative care plan, but it does not directly address respiratory complications. It's more related to bowel function and hydration status.

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Correct Answer is D

Explanation

- A: This choice is incorrect because a flat prone position is not safe or correct for a sigmoidoscopy; the client should be in a left lateral or Sims' position.
- B: This choice is not directly related to the immediate need of correcting the client's position for the procedure.
- C: Assuming care of the client does not address the immediate issue of the client's incorrect positioning for the sigmoidoscopy.
- D: Demonstrating the correct positioning ensures the safety and effectiveness of the procedure, which is the nurse's responsibility.

A. Raise head of bed until at a 90-degree angle. B. Place bed in reverse Trendelenburg position. C. Reinforce bed rest until analgesic is effective. D. Position bedside table for client to lean across.

Correct Answer is D

Explanation

- A: Raising the head of the bed to a 90-degree angle may help alleviate the client's nausea, but it is not the most comfortable position for someone experiencing epigastric pain due to pancreatitis. This position may also increase pressure on the diaphragm, which can worsen discomfort.
- B: The reverse Trendelenburg position, where the body is inclined with the head higher than the feet, may be used to promote gastric emptying and reduce reflux, but it is not specifically beneficial for relieving epigastric pain or nausea associated with pancreatitis.
- C: Reinforcing bed rest may be seen as ignoring the client's expressed need for a position change to relieve discomfort. While rest is important, the client's request to sit up and lean forward indicates a need for positional relief of pain.
- D: Positioning a bedside table for the client to lean across can provide the support they need to maintain a forward-leaning position, which is known to relieve epigastric pain by reducing tension on the abdominal region. This position is often instinctively chosen by clients with pancreatitis and should be facilitated by the nurse for comfort and pain relief.

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The nurse is caring for an older adult client who is admitted to the surgical unit following a partial gastrectomy. In addition to frequent position changes, which postoperative intervention is most beneficial for the nurse to perform in preventing respiratory complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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