The perioperative nurse is providing care for a patient who is recovering on the postsurgical unit following a cholecystectomy. The patient has not started ambulating and states he needs to rest in bed. For what complication is the client most at risk? atelectasis shock anemia dehydration
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After surgery it is advised to patients to mobilize as soon as possible to avoid getting in with the risk of atelectasis.
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- Which dietary instruction should the nurse include when teaching a client how to reduce episode of Raynaud syndromeA patient who has end-stage liver disease is experiencing signs and symptoms of hepatic encephalopathy. What interventions should the nurse implement for this patient? What teaching should the nurse provide to the family?A nurse is counseling an older female patient hospitalizedfor dehydration secondary to a urinary tract infection. Thepatient tells the nurse: “I don’t like being in the hospital.There are too many bad bugs in here. I’ll probably go homesicker than I came in.” She also insists that she is goingto get dressed and go home. She has the capacity to makethese decisions. What is the legal responsibility of the nursein this situation?a. To inform the patient that only the primary health careprovider can authorize discharge from a hospital b. To collect the patient’s belongings and prepare the paper-work for the patient’s discharge c. To request a psych consult for the patient and inform herprimary care provider of the resultsd. To explain that the choice carries a risk for increasedcomplications and make sure that the patient has signed arelease form
- The nurse is caring for a client with a Salem-sump double-lumen nasogastric (NG) tube to suction. The client complains of nausea and has mild abdominal distention. What is the nurse’s priority action?You are caring for a client who has been diagonsed with appendicitis . The nurse in charge asked you to assist in the preparaton of this client for surgery in the next four (4) hours. 1. Outline ten (10) of your nursing care management with rationale for this client. 2. The client returns from theater after having appendectomy done. Outline seven (7) immediate post-operative intervention for this client.The nurse provides care for a patient diagnosed with acute cholecystitis. The patient says, "My stomach hurts all the way up to my right shoulder and I am having some nausea. I even vomited twice!" Which prescription does the nurse carry out first? O morphine 15mg IM q4hrs PRN insert NG tube and attach to intermittent low suction O Trimethobenzamide 200 mg rectally TID O NPO
- A patient with a BMI of 40 is scheduled for laparoscopic banding bariatric surgery this morning. The patient is very anxious and says she cannot remember the preoperative instructions provided yesterday. She says she can’t remember what kind of surgery she is having today. What actions should the nurse take?After Mrs. Shower’s CABG, she will be in the ICU for 4 to 6 days if there aren’t any complications. She will then be transferred back to the cardiac unit and stay a few more days before being discharged. As we discussed in class, nutrition education prior to the surgery is not appropriate as it is likely that the Patient will not be able to focus on the education. When she returns to the cardiac unit, you can obtain a detailed diet history for her usual intake at home: 1. Describe what nutrition education you will provide. 2. What are your goals for the education? 3. Describe the return demonstration you will ask Mrs. Showers to show that she understands the education.A nurse is developing a plan of care related to preventionof pressure ulcers for residents in a long-term care facility.Which action would be a priority in preventing a patient fromdeveloping a pressure ulcer?a. Keeping the head of the bed elevated as often as possibleb. Massaging over bony prominencesc. Repositioning bed-bound patients every 4 hoursd. Using a mild cleansing agent when cleansing the skin
- A nurse is assessing a client who has acute pancreatitis. Which of the following findings should the nurse expect?A.HypertensionB.Hyperactive bowel soundsC.Peripheral edemaD.Periumbilical discolorationThe nurse is caring for a patient in the emergency department with complaints of acute abdominal pain, nausea, and vomiting. When the nurse palpates the patient's left lower abdominal quadrant, the patient complains of pain in the right lower quadrant. The nurse will document this as which of the following diagnostic signs of appendicitis? Psoas sign Rovsing sign Murphys sign Bloomberg's sign Postoperative nursing care for a client after an appendectomy should include which of the following interventions Noting the first bowel movement after surgery Measuring abdominal girth every 2 hours Administering sitz bath three times a day Limiting the client’s activity to bathroom privileges A client who had an appendectomy for a perforated appendix returns from surgery with a drain inserted in the incisional site. The nurse understands that the purpose of the drain is to accomplish which of the following? Provide access for wound irrigation Minimize development of scar tissue Decrease…1) The nurse receives an order to administer enteral tube feedings to a client with dysphagia. The order states:Administer 1500 mLs of enteral feeding over 18 hours via infusion pump.What will the mLs per hour be? Round to the nearest whole number. 2) A nurse is caring for a client with a diabetic ulcer which is has a bacterial infection. Identify the lab values the nurse will review to monitor for infection