When providing care for a client on the first postoperative day following an appendectomy, which intervention should the practical nurse implement?

Maintain client in recumbent position.

Apply moist heat for reports of pain.

Restrict ambulation to bathroom only.

Document the first bowel movement.

Answer and Explanation

The Correct Answer is D

Choice A reason: Maintaining the client in a recumbent position is not typically necessary on the first postoperative day following an appendectomy. While it is important to ensure the client is comfortable and to monitor for signs of complications, encouraging mobility as soon as it is safe is generally beneficial. Prolonged bed rest can lead to complications such as deep vein thrombosis (DVT) and respiratory issues. Therefore, this intervention is not the most appropriate for promoting recovery and ensuring the client's well-being.
Choice B reason: Applying moist heat for pain relief is generally not recommended in the immediate postoperative period following an appendectomy. The use of heat can increase blood flow to the surgical site and potentially exacerbate inflammation or swelling. Pain management should be approached with appropriate analgesics as prescribed by the healthcare provider. Additionally, it is crucial to monitor for signs of complications such as infection or hematoma, and moist heat may not be the safest method for addressing postoperative pain in this context.
Choice C reason: Restricting ambulation to the bathroom only may be overly restrictive and can hinder the client's recovery process. Encouraging early and safe ambulation is important to prevent complications like DVT, promote circulation, and support overall recovery. While it is essential to ensure that the client does not overexert themselves, completely restricting movement to only bathroom trips is not conducive to optimal postoperative care. Gradual, supervised ambulation should be encouraged as the client's condition permits.
Choice D reason: Documenting the first bowel movement is a crucial intervention following an appendectomy. It provides important information about the return of gastrointestinal function, which can be affected by both the surgery and anesthesia. Monitoring and recording bowel movements help ensure that the client is not experiencing postoperative ileus, a common complication characterized by a temporary cessation of bowel activity. Early detection of such issues allows for timely intervention and supports the client's overall recovery.

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Correct Answer is A

Explanation

Choice A reason: Hematemesis, or vomiting of blood, is a critical symptom to monitor in a client with esophageal varices. Esophageal varices are enlarged veins in the esophagus that can rupture and bleed due to increased pressure in the portal venous system, a common complication of cirrhosis. Hematemesis indicates a potentially life-threatening variceal bleed that requires immediate medical intervention. Reporting this finding promptly ensures that the healthcare team can take swift action to manage the bleeding and stabilize the client.
Choice B reason: Anorexia, or loss of appetite, is a common symptom in clients with chronic liver disease, including cirrhosis. While it is important to address nutritional concerns, anorexia does not directly indicate a life-threatening complication like variceal bleeding. Monitoring for anorexia is essential for overall health and nutritional support, but it is not the most immediate concern in this scenario.
Choice C reason: Clay-colored stools can indicate a lack of bile in the stool, which may occur due to biliary obstruction or impaired bile flow. While this finding is significant and requires attention, it is not as urgent as hematemesis in the context of esophageal varices. Clay-colored stools may suggest other complications related to liver function but do not indicate an immediate life-threatening situation.
Choice D reason: Brown, foamy urine may indicate the presence of blood or protein in the urine, which can occur in various kidney and urinary tract disorders. While this finding is important to monitor, it is not directly related to esophageal varices or their complications. The primary concern with esophageal varices is the risk of bleeding, which is best indicated by hematemesis.

A. Ask if he understands the consequences of continuing to smoke. B. Encourage the client to substitute cigars for the cigarettes. C. Recommend an acupuncturist to assist with smoking cessation efforts. D. Reinforce information about consequences related to smoking and heart disease. E. Record the client's exact words in the electronic medical record.

Correct Answer is ["A","D","E"]

Explanation

Choice A reason: Asking if the client understands the consequences of continuing to smoke is essential for assessing his level of awareness about the risks associated with smoking, especially after a myocardial infarction. This step helps gauge the client's knowledge and can serve as a starting point for providing further education. It opens up a dialogue where the nurse can discuss the detrimental effects of smoking on cardiovascular health and the increased risk of recurrent heart attacks. Understanding the client's perspective and providing education can foster a more informed decision-making process and may encourage the client to consider quitting smoking.
Choice B reason: Encouraging the client to substitute cigars for cigarettes is not a recommended intervention. Cigars, like cigarettes, contain nicotine and other harmful chemicals. Substituting one form of tobacco for another does not reduce the health risks associated with smoking. Cigars can also lead to nicotine addiction and contribute to heart disease and other health issues. The goal should be to support the client in achieving complete smoking cessation rather than replacing one harmful habit with another. This approach does not align with evidence-based practices for promoting health and reducing cardiovascular risks.
Choice C reason: Recommending an acupuncturist to assist with smoking cessation efforts is an alternative therapy that some individuals may find beneficial. However, it should not be the first-line recommendation. Evidence-based strategies such as nicotine replacement therapy, medications, and counseling should be prioritized. Acupuncture can be considered as a complementary therapy in conjunction with these proven methods. It is important to provide the client with a range of options and support them in choosing the most effective and suitable approach for smoking cessation. However, this option alone does not address the immediate need for education and support regarding the risks of continued smoking.
Choice D reason: Reinforcing information about the consequences related to smoking and heart disease is crucial. Education plays a significant role in helping the client understand the impact of smoking on cardiovascular health. Providing detailed information about how smoking contributes to heart disease, the benefits of quitting, and the potential for improved outcomes can motivate the client to consider cessation. Reinforcement of this information helps to ensure that the client is fully aware of the serious health risks and the importance of quitting smoking to prevent further cardiovascular events.
Choice E reason: Recording the client's exact words in the electronic medical record is important for accurate documentation and continuity of care. This documentation provides a clear record of the client's statements, attitudes, and intentions regarding smoking. It ensures that all members of the healthcare team are informed of the client's position and can tailor their interventions accordingly. Accurate documentation also helps in tracking the client's progress and responses to interventions over time, facilitating a coordinated and comprehensive approach to care.

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When providing care for a client on the first postoperative day following an appendectomy, which intervention should the practical nurse implement?

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Naxlex Comprehensive Predictor Exams

A client with chronic cirrhosis has esophageal varices. It is most important for the practical nurse (PN) to report which finding to the charge nurse?

Correct Answer is A

Explanation

A male client who recently had a myocardial infarction tells the practical nurse (PN) that he refuses to give up his habit of smoking two packs of cigarettes daily. Which intervention(s) should the PN implement? Select all that apply.

Correct Answer is ["A","D","E"]

Explanation

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