The nurse is providing teaching to a patient following a gastric bypass. Which statement by the patient indicates an understanding of the need for lifelong monitoring and lifestyle changes?

A. A high specific gravity of urine typically indicates concentrated urine, which can occur in dehydration; however, moist mucous membranes suggest adequate hydration. This combination does not indicate severe dehydration.
B. A low specific gravity of urine usually indicates dilute urine, which is not typical in dehydration; it suggests the kidneys are not concentrating urine due to good fluid intake or other factors. While pale skin can indicate poor perfusion, this option does not specifically indicate severe dehydration.
C. A depressed fontanelle (soft spot on the head) and a capillary refill time greater than 4 seconds are significant indicators of severe dehydration in infants. Depressed fontanelles suggest that the infant is not receiving enough fluids, and prolonged capillary refill time indicates poor perfusion and dehydration.
D. Moist skin and mucous membranes indicate adequate hydration. Flushed skin may occur with certain conditions but does not suggest severe dehydration. This option reflects a well-hydrated status rather than dehydration.

A. While monitoring the surgical site is important, changing the dressing is not the highest priority immediately post-operatively. The initial focus should be on assessing the patient's stability and managing any complications rather than performing a dressing change.
B. Assessing bowel sounds is important to evaluate gastrointestinal function, particularly after gastrointestinal surgery. However, this can be done after ensuring that the patient is stable and that their airway, breathing, and circulation are prioritized. While important, it is not the immediate priority.
C. If the patient has a nasogastric (NG) tube in place and is experiencing nausea, this may require attention, as it can indicate a blockage or discomfort. However, repositioning the NG tube may not be the first intervention to prioritize in the immediate post-operative setting.
D. This intervention is critical for multiple reasons. Elevating the head of the bed helps reduce the risk of aspiration, improves breathing by enhancing lung expansion, and aids in reducing pressure on the surgical site. After abdominal surgery, especially in obese patients, elevating the head can also promote comfort and facilitate early ambulation.