The nurse is teaching a client who is preparing for surgery. Which teaching about a Jackson-Pratt drain will the nurse include?

"The bulb-like system will stay in place permanently after your surgery."

"You will receive medication through this device."

"This drain minimizes the chance for bacteria to enter the surgical site."

"It provides a way to remove drainage and blood from the surgical wound."

Answer and Explanation

The Correct Answer is D

A. "The bulb-like system will stay in place permanently after your surgery.": A Jackson-Pratt drain is a temporary measure used to collect drainage from a surgical site. It is designed to be removed once the output decreases and the surgical site is healing properly, so it does not remain in place permanently.

B. "You will receive medication through this device.": The Jackson-Pratt drain is specifically for draining fluids from the surgical area and does not administer medication. Medications are typically given through separate methods, such as IV or oral administration.

C. "This drain minimizes the chance for bacteria to enter the surgical site.": While proper drainage can help reduce the risk of complications associated with fluid accumulation, the main purpose of the drain is to facilitate the removal of fluids rather than to directly minimize bacterial entry. Maintaining a clean and sterile technique when handling the drain is essential to prevent infection.

D. "It provides a way to remove drainage and blood from the surgical wound.": This accurately reflects the primary function of the Jackson-Pratt drain. It allows for continuous drainage of excess fluids and blood from the surgical site, helping to prevent complications such as hematomas or seromas and promoting better healing outcomes.

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Correct Answer is D

Explanation

A. Use the cane on the same side as the injured or weaker leg: This approach is incorrect. The cane should be used on the opposite side of the weaker leg to provide better support and balance during ambulation. Using the cane on the same side would not provide adequate stability and could increase the risk of falling.

B. Move the cane and the stronger leg forward together: This step is not recommended. The proper technique involves moving the cane first, followed by the weaker leg, and then bringing the stronger leg forward. This sequence helps maintain stability and balance while walking.

C. Adjust the cane height so the handle is above the waist level: The cane should be adjusted so that the handle is at the level of the wrist when the client is standing upright, which allows for proper elbow flexion while using the cane. If the handle is too high, it can lead to poor posture and increased strain.

D. Hold the cane on the side opposite the injured or weaker leg: This is the essential step for ensuring stability and safety when using a cane. By holding the cane on the opposite side, the client can use the cane for support while stepping forward with the weaker leg, enhancing balance and reducing the risk of falls. This technique allows for better weight distribution and improved mobility.

A. Partial thromboplastin time (PTT) 65 seconds B. Hematocrit 45% C. White blood cell count 8.000/mm3 D. Platelets

Correct Answer is A

Explanation

A. Partial thromboplastin time (PTT) 65 seconds: The normal PTT range is typically between 25 to 35 seconds for patients not on anticoagulants. For a patient receiving heparin therapy, the therapeutic PTT range is usually 1.5 to 2.5 times the normal value, which translates to approximately 60 to 100 seconds. A PTT of 65 seconds is at the lower end of the therapeutic range and may require adjustment in dosage or closer monitoring, especially if there are concerns about achieving adequate anticoagulation for the treatment of a pulmonary embolism. It is important to report this value to the provider.

B. Hematocrit 45%: A hematocrit of 45% is within the normal range for adult females (38% to 47%) and males (40% to 54%). This value does not indicate any immediate concern related to heparin therapy or the treatment of a pulmonary embolism.

C. White blood cell count 8.000/mm³: A white blood cell count of 8,000/mm³ is within the normal range (4,500 to 11,000/mm³) and does not indicate any infection or inflammatory process that requires immediate reporting.

D. Platelets: The specific platelet count value is not provided. However, heparin therapy can lead to thrombocytopenia (low platelet count), so if the platelet count is below 150,000/mm³, it should be reported to the provider. Without the specific value, it is not possible to determine if this requires reporting.

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The nurse is teaching a client who is preparing for surgery. Which teaching about a Jackson-Pratt drain will the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When instructing a client on the proper use of a cane, which step is essential to ensure stability and safety?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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