When administering belladonna and opium (B & O) suppositories to a client after a prostatectomy, it is important for the practical nurse (PN) to implement which action?
Place the suppository high in the rectum.
Allow the suppository to soften before insertion.
Freeze the suppository prior to insertion.
Avoid use of a lubricant with insertion of the suppository.
The Correct Answer is A
A. Place the suppository high in the rectum: Inserting the suppository high in the rectum ensures that it is positioned beyond the anal sphincter, where it can be effectively absorbed. Proper placement maximizes the medication's effect and prevents expulsion, which is critical for achieving pain relief and antispasmodic benefits after prostate surgery.
B. Allow the suppository to soften before insertion: Allowing the suppository to soften may make it difficult to insert and can result in incomplete delivery of the medication. A firm suppository is easier to insert properly and ensures accurate medication placement and effectiveness.
C. Freeze the suppository prior to insertion: Freezing the suppository is not recommended because it can make it too hard and sharp, potentially causing trauma to delicate rectal tissues, especially in a postoperative client who may already have increased sensitivity and healing tissues.
D. Avoid use of a lubricant with insertion of the suppository: Using a water-soluble lubricant is important during suppository insertion to minimize mucosal trauma and facilitate smoother placement. Avoiding lubrication can cause unnecessary discomfort and increase the risk of rectal injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Offer fluids: Offering fluids is not appropriate when the client shows signs of central cyanosis, as it does not address impaired oxygenation and may pose an aspiration risk if the client is hypoxic or has altered mental status.
B. Administer oxygen: Cyanosis of the lips and tongue indicates poor oxygen saturation and tissue hypoxia. Administering oxygen is the priority action to improve oxygen delivery and prevent respiratory compromise.
C. Ask about pain: While assessing pain is important, it is not the priority in the presence of cyanosis, which reflects a potentially life-threatening oxygenation issue requiring immediate intervention.
D. Provide mouth care: Mouth care is not urgent and does not address the underlying problem of hypoxia. It should be deferred until after the client’s oxygenation status is stabilized.
Correct Answer is C
Explanation
A. Discuss a low sodium diet: While teaching about a low sodium diet is important in managing fluid balance and hypertension, it is not the immediate intervention needed to address the acute symptoms and risks associated with the client's current condition.
B. Provide only distilled water: Distilled water is not necessary in managing acute kidney injury. Fluid intake management should be based on specific electrolyte and fluid needs, and the focus should be on controlling volume overload rather than the type of water provided.
C. Monitor for dependent pitting edema: Monitoring for pitting edema is critical because it provides immediate information about fluid overload, which is common with acute kidney injury. Assessing for edema provides information about the extent of fluid retention and helps evaluate the effectiveness of interventions aimed at managing fluid balance.
D. Use a cushion when sitting: Using a cushion may improve comfort but does not address the life-threatening complications of electrolyte imbalance, hypertension, and mental status changes associated with acute kidney injury. Priority should be on assessing and managing systemic symptoms.
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