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A nurse is providing discharge education to a patient who has undergone a laparoscopic cholecystectomy. During the immediate recovery period, the nurse should recommend what foods?
- A. High-fiber foods
- B. Low-purine, nutrient-dense foods
- C. Low-fat foods high in proteins and carbohydrates
- D. Foods that are low-residue and low in fat
Correct Answer: C
Rationale: The nurse encourages the patient to eat a diet that is low in fats and high in carbohydrates and proteins immediately after surgery. There is no specific need to increase fiber or avoid purines. A low-residue diet is not indicated.
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A nurse is creating a care plan for a patient with acute pancreatitis. The care plan includes reduced activity. What rationale for this intervention should be cited in the care plan?
- A. Bed rest reduces the patients metabolism and reduces the risk of metabolic acidosis.
- B. Reduced activity protects the physical integrity of pancreatic cells.
- C. Bed rest lowers the metabolic rate and reduces enzyme production.
- D. Inactivity reduces caloric need and gastrointestinal motility.
Correct Answer: C
Rationale: The acutely ill patient is maintained on bed rest to decrease the metabolic rate and reduce the secretion of pancreatic and gastric enzymes. Staying in bed does not release energy from the body to fight the disease.
A nurse is assessing a patient who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the patients pain, the nurse should anticipate that it may radiate to what region?
- A. Left upper chest
- B. Inguinal region
- C. Neck or jaw
- D. Right shoulder
Correct Answer: D
Rationale: The patient may have biliary colic with excruciating upper right abdominal pain that radiates to the back or right shoulder. Pain from cholecystitis does not typically radiate to the left upper chest, inguinal area, neck, or jaw.
A nurse who provides care in a walk-in clinic assesses a wide range of individuals. The nurse should identify which of the following patients as having the highest risk for chronic pancreatitis?
- A. A 45-year-old obese woman with a high-fat diet
- B. An 18-year-old man who is a weekend binge drinker
- C. A 39-year-old man with chronic alcoholism
- D. A 51-year-old woman who smokes one-and-a-half packs of cigarettes per day
Correct Answer: C
Rationale: Excessive and prolonged consumption of alcohol accounts for approximately 70% to 80% of all cases of chronic pancreatitis.
A patient with gallstones has been prescribed ursodeoxycholic acid (UDCA). The nurse understands that additional teaching is needed regarding this medication when the patient states:
- A. It is important that I see my physician for scheduled follow-up appointments while taking this medication.
- B. I will take this medication for 2 weeks and then gradually stop taking it.
- C. If I lose weight, the dose of the medication may need to be changed.
- D. This medication will help dissolve small gallstones made of cholesterol.
Correct Answer: B
Rationale: Ursodeoxycholic acid (UDCA) has been used to dissolve small, radiolucent gallstones composed primarily of cholesterol. This drug can reduce the size of existing stones, dissolve small stones, and prevent new stones from forming. Six to 12 months of therapy is required in many patients to dissolve stones, and monitoring of the patient is required during this time. The effective dose of medication depends on body weight.
A patient has had a laparoscopic cholecystectomy. The patient is now complaining of right shoulder pain. What should the nurse suggest to relieve the pain?
- A. Aspirin every 4 to 6 hours as ordered
- B. Application of heat 15 to 20 minutes each hour
- C. Application of an ice pack for no more than 15 minutes
- D. Application of liniment rub to affected area
Correct Answer: B
Rationale: If pain occurs in the right shoulder or scapular area (from migration of the CO2 used to insufflate the abdominal cavity during the procedure), the nurse may recommend use of a heating pad for 15 to 20 minutes hourly, walking, and sitting up when in bed. Aspirin would constitute a risk for bleeding.