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After teaching a client who is recovering from laparoscopic cholecystectomy surgery, the nurse assesses the client's understanding. Which statement by the client indicates a correct understanding of the teaching?
- A. I should avoid fatty foods for a few weeks.
- B. Drinking at least 2 liters of water each day is suggested.
- C. I can resume normal activities immediately.
- D. I should expect severe pain for a few days.
Correct Answer: B
Rationale: Clients recovering from laparoscopic cholecystectomy should maintain adequate hydration to support recovery and prevent complications. Drinking at least 2 liters of water daily is a standard recommendation. Avoiding fatty foods is important but typically advised for longer than a few weeks. Immediate resumption of normal activities is not recommended, and severe pain is not expected.
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A nurse plans care for a client who has acute pancreatitis and is prescribed nothing by mouth (NPO). With which health care team members should the nurse collaborate to provide appropriate nutrition to the client? (Select all that apply.)
- A. Registered dietitian
- B. Nursing assistant
- C. Clinical pharmacist
- D. Certified herbalist
- E. Health care provider
Correct Answer: A,C,E
Rationale: Clients who are prescribed NPO while experiencing an acute pancreatitis episode may need enteral or parenteral nutrition. The nurse should collaborate with the registered dietitian, clinical pharmacist, and health care provider to determine the best nutritional intervention. The nursing assistant and certified herbalist would not assist with this clinical decision.
A nurse cares for a client who reports free air pain after a laparoscopic cholecystectomy. Which action should the nurse take?
- A. Assist the client with early ambulation.
- B. Apply a cold compress to the abdomen.
- C. Provide a warm beverage to relieve pain.
- D. Encourage coughing and deep breathing every hour.
Correct Answer: A
Rationale: The client who has undergone a laparoscopic cholecystectomy may report free air pain due to retention of carbon dioxide in the abdomen. The nurse assists the client with early ambulation to promote absorption of the carbon dioxide. Cold compresses and drinking a warm beverage would not be helpful. Coughing and deep breathing are important postoperative activities, but they are not related to discomfort from carbon dioxide.
A nurse cares for a client who is prescribed 4 mg of calcium gluconate to infuse over 5 hours. The pharmacy provides 2 premixed infusion bags with 2 mg of calcium gluconate in 100 mL of D5W. At what rate should the nurse administer this medication? (Record your answer using a whole number.)
Correct Answer: 40 mL/hr
Rationale: Two bags of 2 mg calcium gluconate in 100 mL D5W each provide a total of 4 mg in 200 mL. To infuse over 5 hours: 200 mL ÷ 5 hr = 40 mL/hr.
A nurse cares for a client who is prescribed patient-controlled analgesia (PCA) after a cholecystectomy. The client states, 'When I wake up, I am in pain.' Which action should the nurse take?
- A. Administer intravenous morphine while the client sleeps.
- B. Encourage the client to use the PCA pump upon awakening.
- C. Administer intravenous morphine while the client is awake.
- D. Ask a family member to initiate the PCA pump for the client.
Correct Answer: B
Rationale: The nurse should encourage the client to use the PCA pump prior to napping and upon awakening. Administering additional intravenous morphine while the client sleeps places the client at risk for respiratory depression. Only the client should push the pain button on a PCA pump.
A nurse cares for a client who presents with tachycardia and prostration related to biliary colic. Which actions should the nurse take? (Select all that apply.)
- A. Contact the provider immediately.
- B. Lower the head of the client.
- C. Decrease intravenous fluids.
- D. Ask the client to bear down.
- E. Administer prescribed opioids.ã??ã??ã?ª
Correct Answer: A,B
Rationale: Clients who are experiencing biliary colic may present with tachycardia, pallor, diaphoresis, prostration, or other signs of shock. The nurse should stay with the client, lower the client's head, and contact the provider or Rapid Response Team for immediate assistance. Decreasing fluids or administering opioids could worsen the client's condition.