The nurse is providing discharge teaching to a client after a total hip replacement. The teaching should include instructions to:
Avoid crossing the legs while sitting.
Eliminate Vitamin K from the diet.
Follow a home exercise program.
Use a raised toilet seat.
Increase high-impact activities.
Correct Answer : A,C,D
Choice a reason:
Avoiding crossing the legs while sitting is crucial after a total hip replacement to prevent dislocation of the new joint. Crossing the legs can put undue pressure on the hip joint and may lead to misalignment or increased strain during the healing process.
Choice b reason:
Eliminating Vitamin K from the diet is not typically recommended after a total hip replacement. Vitamin K is essential for blood clotting, and maintaining a consistent intake is important, especially if the client is on anticoagulant therapy to prevent deep vein thrombosis. Sudden changes in Vitamin K intake can affect the efficacy of anticoagulants like warfarin.
Choice c reason:
Following a home exercise program is an essential part of recovery after a total hip replacement. Exercises help strengthen the muscles around the new joint, improve flexibility, and increase range of motion. It's important that these exercises are done regularly and as instructed by a physical therapist.
Choice d reason:
Using a raised toilet seat after hip replacement surgery helps to prevent excessive flexion at the hip, which can risk dislocating the new joint. It also makes it easier for the client to sit down and stand up with less strain on the hip.
Choice e reason:
Increasing high-impact activities is not recommended after a total hip replacement, especially in the early stages of recovery. High-impact activities can put excessive stress on the new joint and may lead to complications. Low-impact activities such as walking, swimming, or cycling are generally more appropriate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Maintaining normal salt and fluid intake is crucial for patients on lithium. Lithium can affect sodium levels in the body, and consistent sodium intake helps to keep lithium levels stable. Patients should be advised to drink adequate fluids to prevent dehydration but avoid excessive fluid intake, which could alter lithium levels and potentially lead to toxicity¹²³⁴.
Choice B Reason:
Drinking twice the usual amount of fluids daily is not recommended for patients on lithium unless directed by a healthcare provider. Excessive fluid intake can lead to changes in lithium levels and increase the risk of lithium toxicity. Patients should aim to consume a sufficient amount of fluids to stay hydrated, especially in situations that may lead to dehydration, such as during hot weather or illness.
Choice C Reason:
Avoiding aged cheese, processed meats, and red wine is generally advised for patients taking monoamine oxidase inhibitors (MAOIs), not lithium. These foods can contain high levels of tyramine, which can interact with MAOIs. However, there are no specific dietary restrictions for lithium regarding these foods. Patients should follow a balanced diet and consult with their healthcare provider for personalized dietary advice.
Choice D Reason:
Doubling the lithium dose if diarrhea or vomiting occurs is incorrect and potentially dangerous. If a patient experiences diarrhea or vomiting, it can affect lithium absorption and increase the risk of toxicity. Instead, patients should contact their healthcare provider for guidance. Adjustments to the medication regimen should only be made under medical supervision.
Correct Answer is C
Explanation
Choice A reason:
Administering an antiemetic is an important intervention in the PACU, especially if the patient is experiencing nausea or has a history of postoperative nausea and vomiting (PONV). However, it is not the first priority. Antiemetics work by blocking the neurotransmitters that trigger the vomiting reflex. Medications such as ondansetron or promethazine may be used.
Choice B reason:
Applying sequential compression devices is a preventive measure against deep vein thrombosis (DVT), which is a risk due to immobility after surgery. These devices help improve venous return from the lower limbs by applying intermittent pressure. While important, this intervention follows after the assessment of vital signs.
Choice C reason:
Assessing vital signs is the first and foremost priority when a patient is transferred to the PACU. Vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, provide immediate information about the patient's hemodynamic status and can indicate the need for urgent interventions. Any evidence of respiratory or circulatory compromise requires immediate attention.
Choice D reason:
Hanging the Lactated Ringers solution is part of managing the patient's fluid status postoperatively. Lactated Ringers is an isotonic solution that helps to replace lost fluids and maintain electrolyte balance. While important for patient care, it is not the initial priority upon arrival in the PACU.
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