The nurse is caring for the patient who is 1-day status post splenectomy. The patient complains of pain of a 3 on inspiration. What would be the most appropriate priority nursing intervention for this patient?

Contact the surgeon to obtain orders for a nebulizer treatment from respiratory therapy.

Provide the patient with a heating pad alternated with a cold pack for incisional pain.

Medicate with opioids for pain and assist the patient to deep breathe, cough, and ambulate.

Contact the surgeon to request a chest x-ray and a laboratory draw for CBC with differential.

Answer and Explanation

The Correct Answer is C

A. Contact the surgeon to obtain orders for a nebulizer treatment from respiratory therapy. A nebulizer is typically not the initial intervention for mild post-operative pain or mild respiratory discomfort due to pain with inspiration.

B. Provide the patient with a heating pad alternated with a cold pack for incisional pain. While heat or cold therapy can help with pain, opioid pain management with encouragement to perform deep breathing exercises is more effective for post-splenectomy patients.

C. Medicate with opioids for pain and assist the patient to deep breathe, cough, and ambulate. Pain management combined with encouraging deep breathing, coughing, and early ambulation helps prevent post-operative complications like atelectasis and pneumonia, which are common after abdominal surgeries.

D. Contact the surgeon to request a chest x-ray and a laboratory draw for CBC with differential. This intervention might be necessary if there were signs of infection or other complications, but mild pain with inspiration on the first day post-op does not typically warrant imaging or labs.

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Correct Answer is B

Explanation

A. Myxedema: Myxedema is associated with hypothyroidism, not multiple myeloma.

B. Pathologic fracture: Advanced multiple myeloma causes bone demineralization and osteolytic lesions, making bones fragile and increasing the risk for pathologic fractures.

C. Retinopathy: Retinopathy is commonly associated with diabetes or hypertension, not with multiple myeloma.

D. Gastrointestinal bleeding: Gastrointestinal bleeding is not a typical complication of multiple myeloma.

A. Initiate a 2 L/day fluid restriction. B. Assist with administering a blood transfusion. C. Withhold opioids to avoid dependence. D. Encourage exercise.

Correct Answer is B

Explanation

A. Initiate a 2 L/day fluid restriction: Hydration is crucial in sickle cell crisis to prevent further sickling and reduce blood viscosity. A fluid restriction would worsen the crisis.

B. Assist with administering a blood transfusion: Blood transfusions are commonly given during sickle cell crisis to manage anemia and reduce the concentration of sickled cells, which can improve oxygen delivery and relieve pain.

C. Withhold opioids to avoid dependence: Pain management, including opioids if needed, is essential during a sickle cell crisis. The risk of dependence is secondary to controlling acute pain.

D. Encourage exercise: Rest is recommended during a crisis to reduce oxygen demand and prevent further sickling. Exercise would increase oxygen needs, worsening the crisis.

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The nurse is caring for the patient who is 1-day status post splenectomy. The patient complains of pain of a 3 on inspiration. What would be the most appropriate priority nursing intervention for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting in planning care for a client who has advanced multiple myeloma. When planning care the nurse should recognize that the client is at risk for which of the following complications?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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