The patient who is morbidly obese has just undergone gastric bypass surgery. Which immediate post-operative intervention has the greatest priority?
Change the surgical dressing.
Auscultate bowel sounds.
Reposition the NG tube if patient is nauseated.
Elevate the head of the bed at least 30 degrees.
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2.5"]
Explanation
Rate (ml/min) = Total Volume (ml) / Time (min).
The total volume of the pantoprazole IV is 10 ml, and the time frame for administration is 4 minutes.
Therefore, the calculation would be: Rate = 10 ml / 4 min, which equals 2.5 ml per minute. So, the nurse should administer 2.5 ml of pantoprazole IV per minute to deliver a total of 40 mg over the 4-minute period
Correct Answer is D
Explanation
A. An EGD involves inserting a flexible tube with a camera through the mouth into the esophagus, stomach, and duodenum. It often requires the patient to be NPO (nothing by mouth) for several hours beforehand, but it can typically be done before other imaging tests.
B. A barium enema is a radiologic examination of the large intestine that uses a barium contrast solution. Patients may need to follow a special diet and take laxatives prior to the test. It's often done earlier in the testing schedule to clear the bowel before other procedures.
C. An abdominal ultrasound is a non-invasive imaging test that does not require any special preparations, although patients are often advised to fast for a few hours beforehand for optimal results. It can typically be scheduled relatively flexibly in relation to other tests.
D. An abdominal CT scan may involve the use of contrast agents, which can be given orally or intravenously. If the patient has had a barium study (like a barium enema) before the CT scan, it’s generally recommended to schedule the CT scan last. This is because residual barium in the gastrointestinal tract can interfere with the imaging results of a CT scan.
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