Which activity should a client avoid following a transsphenoidal hypophysectomy?
Deep breathing exercises.
Bending over to weed the garden.
Drinking plenty of fluids.
Walking short distances.
The Correct Answer is B
A. Deep breathing exercises is incorrect. Deep breathing exercises are generally encouraged to help with lung expansion and oxygenation following surgery. However, patients should avoid activities that put pressure on the surgical site, such as bending over or lifting heavy objects, but deep breathing is typically safe unless contraindicated.
B. Bending over to weed the garden is correct. After a transsphenoidal hypophysectomy, patients should avoid bending over or activities that could increase intracranial pressure (ICP), such as gardening, lifting heavy objects, or straining. Bending over can increase pressure in the sinus cavities and may affect the healing process of the surgical site.
C. Drinking plenty of fluids is incorrect. Drinking fluids is generally encouraged after surgery to maintain hydration and promote healing. However, some restrictions may apply if there is a risk for diabetes insipidus or fluid imbalance, but the act of drinking fluids itself is typically recommended.
D. Walking short distances is incorrect. Walking short distances is usually encouraged after surgery to promote circulation and prevent complications like deep vein thrombosis (DVT). As long as the patient is feeling stable, walking can help recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Monitor blood pressure closely for fluctuations is correct. After an adrenalectomy for pheochromocytoma, it is critical to closely monitor the client's blood pressure. Pheochromocytomas are tumors of the adrenal glands that cause excessive production of catecholamines (like epinephrine and norepinephrine), leading to severe hypertension. Postoperatively, the sudden removal of the tumor may cause blood pressure fluctuations, including hypotension after the excess catecholamines are no longer being produced. Monitoring blood pressure is key to detecting complications like hypotension or hypertensive crises early.
B. Check the client's urine output every hour is incorrect. While urine output is important to monitor in general postoperative care, it is not the priority in this case. The more immediate concern following adrenalectomy for pheochromocytoma is blood pressure control and hemodynamic stability, not just urine output.
C. Evaluate the client's pain level using a numeric scale is incorrect. While managing pain is essential, the priority assessment postoperatively for this particular procedure is to monitor for hemodynamic changes, particularly due to the risk of fluctuating blood pressure. Pain can be managed after addressing the primary concerns.
D. Assess the surgical site for signs of infection is incorrect. While infection is a concern for any postoperative patient, the most immediate risk after adrenalectomy for pheochromocytoma is hemodynamic instability due to catecholamine imbalance. Monitoring blood pressure takes precedence over checking for infection in the early postoperative period.
Correct Answer is B
Explanation
A. Battery involves physical contact or touching a person without consent. Since no physical action was taken, battery does not apply in this case.
B. Assault is correct. Assault is defined as a threat or attempt to make bodily contact with another person without their consent, causing the person to fear imminent harm. The AP's threat to restrain the client if they don't comply fits this definition.
C. False imprisonment involves unlawfully restricting a person’s freedom of movement, such as restraining them without medical or legal justification. Although the AP threatened restraint, no action was taken yet, so this tort does not apply—yet.
D. Invasion of privacy involves unauthorized access or disclosure of personal information, which is unrelated to this situation.
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