Which activity should be restricted for a client following a transsphenoidal hypophysectomy surgery?
Climbing stairs.
Heavy lifting.
Sexual intercourse.
Breathing exercises.
The Correct Answer is B
Choice A rationale
Climbing stairs does not typically lead to an increase in intracranial pressure (ICP) or disrupt the surgical site following transsphenoidal hypophysectomy. Post-operative care focuses on preventing activities that strain the surgical area or elevate ICP, which could compromise healing or lead to cerebrospinal fluid (CSF) leakage. Therefore, this activity is generally not restricted.
Choice B rationale
Heavy lifting significantly increases intra-abdominal and intrathoracic pressure, which directly translates to increased intracranial pressure. This elevation in ICP can disrupt the fragile surgical site in the sphenoid sinus, leading to complications such as cerebrospinal fluid (CSF) leakage or hemorrhage, thereby impeding proper healing and recovery.
Choice C rationale
Sexual intercourse can lead to increased exertion and potential Valsalva maneuvers, which temporarily elevate intracranial pressure. While not as consistently impactful as heavy lifting, the potential for increased pressure and strain on the healing surgical site warrants restriction to minimize the risk of complications such as cerebrospinal fluid leakage.
Choice D rationale
Breathing exercises, such as deep breathing and incentive spirometry, are crucial post-operatively to prevent pulmonary complications like atelectasis and pneumonia. These exercises do not increase intracranial pressure or strain the surgical site; instead, they promote lung expansion and optimize oxygenation, aiding in overall recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
Choice A rationale
Administering diuretics in SIADH can worsen hyponatremia by promoting water excretion with a concomitant loss of sodium, further diluting serum sodium concentration. The underlying issue in SIADH is excessive antidiuretic hormone leading to water retention, not primarily excess extracellular fluid that needs diuresis.
Choice B rationale
Increasing fluid intake is contraindicated in SIADH. The syndrome involves excessive reabsorption of water, leading to dilutional hyponatremia and fluid overload. Increasing fluid intake would exacerbate these issues, further lowering serum sodium levels and potentially leading to cerebral edema.
Choice C rationale
Restricting fluid intake is a cornerstone of SIADH management. By limiting water intake, the body's excessive water retention is mitigated, allowing serum sodium concentration to rise towards normal levels. This helps prevent further dilution of electrolytes and reduces the risk of fluid overload and cerebral edema.
Choice D rationale
Administering hypertonic 3% saline is an effective treatment for symptomatic severe hyponatremia in SIADH. This solution provides a concentrated source of sodium, helping to raise serum sodium levels by drawing water out of cells and into the extracellular space, thereby correcting the dilutional hyponatremia.
Correct Answer is C
Explanation
Choice A rationale
Gonorrhea is a sexually transmitted infection caused by the bacterium *Neisseria gonorrhoeae*. This gram-negative diplococcus primarily infects mucous membranes of the reproductive tract, mouth, and rectum, leading to symptoms like discharge and dysuria. It is not caused by a protozoan.
Choice B rationale
Chlamydia is a sexually transmitted infection caused by the obligate intracellular bacterium *Chlamydia trachomatis*. This bacterium infects columnar epithelial cells, particularly in the genitourinary tract, often leading to asymptomatic infections or symptoms like urethritis and cervicitis. It is not a protozoal infection.
Choice C rationale
Trichomoniasis is a sexually transmitted infection caused by the anaerobic flagellated protozoan parasite *Trichomonas vaginalis*. This microorganism infects the urogenital tract, leading to vaginitis in females and urethritis in males, characterized by symptoms like itching, burning, and discharge.
Choice D rationale
Syphilis is a sexually transmitted infection caused by the spirochete bacterium *Treponema pallidum*. This bacterium can disseminate throughout the body, causing a multi-stage disease with diverse clinical manifestations affecting skin, mucous membranes, and internal organs. It is not caused by a protozoan.
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