Nokea
The nurse is teaching a client who is undergoing brachytherapy about what to immediately report to her health care provider. Which signs and symptoms would be included in this teaching? (Select all that apply.)
- A. Constipation for 3 days
- B. Severe diarrhea
- C. Abdominal pain
- D. Visible blood in the urine
- E. Heavy vaginal bleeding
Correct Answer: C,D,E
Rationale: Health teaching for a client having brachytherapy should emphasize reporting abdominal pain, visible blood in the urine, and heavy vaginal bleeding. Severe diarrhea, urethral burning, extreme fatigue, and a fever over 100°F should also be reported. Constipation for 3 days is not typically a critical symptom to report immediately in this context.
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The nurse is caring for a postoperative client following an anterior colporrhaphy. What action can be delegated to the unlicensed assistive personnel (UAP)?
- A. Reviewing the hematocrit and hemoglobin results
- B. Reading the hematocrit and hemoglobin results to an old grandson
- C. Assessing the level of pain and any drainage
- D. Drawing a shallow hot bath for comfort measures
Correct Answer: D
Rationale: The UAP is able to provide comfort through a bath. The registered nurse should review any laboratory results, complete any teaching, and assess pain and discharge.
A client has scheduled brachytherapy sessions and states that she feels as though she is not safe around her family. What is the best response by the nurse?
- A. You are only radioactive when the radioactive implant is in place.
- B. To be totally safe, it is a good idea to sleep in a separate room.
- C. It is best to stay a safe distance from friends or family between treatments.
- D. You should use a separate bathroom from the rest of the family.
Correct Answer: A
Rationale: In brachytherapy, the surgeon inserts an applicator into the uterus. After placement is verified, the radioactive isotope is placed in the applicator for several minutes for a single treatment. There are no restrictions for the woman to stay away from her family or the public between treatments.
A 55-year-old post-menopausal woman is assessed by the nurse with a history of dyspareunia, backache, pelvic pressure, urinary tract infections, and frequent urinary urgency. Which condition does the nurse suggest?
- A. Ovarian cyst
- B. Rectocele
- C. Cystocele
- D. Fibroid
Correct Answer: C
Rationale: Dyspareunia, backache, pelvic pressure, urinary tract infections, and urinary urgency are all symptoms of a cystocele, a protrusion of the bladder through the vaginal wall. Ovarian cysts are rare after menopause, a rectocele is associated with constipation, hemorrhoids, and local impaction. Fibroids are associated with heavy bleeding.
The nurse is doing preoperative teaching for a client who is scheduled for removal of cervical polyps in the office. Which statement by the client indicates a correct understanding of the procedure?
- A. There is a blood flow to the area.
- B. There should be little to no discomfort during the procedure.
- C. There may be a lot of bleeding after the polyp is removed.
- D. The client may prevent a blood flow to the area.
Correct Answer: B
Rationale: Polyp removal is a simple office procedure with the client feeling no pain. The other responses are incorrect. Cervical polyps are the most common benign growth of the cervix. Cautery is used to stop any bleeding, and there is no evidence that cervical polyps have a relationship to childbearing.
A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best?
- A. Suggest increasing vitamins and supplements daily.
- B. Discuss the value of a balanced diet and exercise.
- C. Reinforce that weight gain may be inevitable.
- D. Teach that estrogen cream inserted vaginally may help.
Correct Answer: D
Rationale: Use of vaginal estrogen cream and gentle dilation can help with vaginal changes and loss of libido. Weight gain and masculinization are misperceptions after a vaginal hysterectomy. Vitamins, supplements, a balanced diet, and exercise are helpful for healthy living, but are not necessarily going to increase libido.