A case manager is preparing a discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first?

Inadequate food supply

Limited social support

Low pain tolerance

Decreased self-esteem

Answer and Explanation

The Correct Answer is C

A.   Inadequate food supply is important but might not be the most immediate concern following coronary artery bypass grafting surgery.
B.   Limited social support is significant for the client's recovery but might not directly impact the immediate post-operative care.
C.   Low pain tolerance after a major surgery like coronary artery bypass grafting can impede recovery, affect mobility, and hinder the client's ability to participate in rehabilitation exercises or manage post-operative pain effectively. Addressing pain
tolerance is crucial for post-operative recovery.
D.   Decreased self-esteem, while important for the client's overall well-being, might not be an immediate priority in the early stages following surgery compared to managing physical recovery and pain tolerance.

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Correct Answer is B

Explanation

A: Providing a 10-minute rest period prior to meals can be beneficial for some clients, but it is not specifically related to the prevention of aspiration in clients with dysphagia. Rest periods do not directly facilitate safer swallowing processes.

B: Elevating the head of the client's bed to 30° during mealtime is the correct technique for a client with dysphagia. This position helps prevent aspiration, which can occur if food or liquids enter the lungs instead of going down the esophagus. The semi-upright position aids in the proper alignment of the esophagus and reduces the risk of choking.

C: Withholding fluids until the end of the meal is not an appropriate technique for a client with dysphagia. Fluids are often needed to help swallow and clear the mouth of food particles. Additionally, providing fluids throughout the meal can help prevent dehydration.

D: Instructing the client to place her chin toward her chest when swallowing can help prevent aspiration in clients with dysphagia. However, this technique should be used in conjunction with other methods, such as the correct positioning of the bed, to ensure safety and effectiveness.

A. Two nurses had a heated disagreement about a scheduling issue. B. A client is refusing care from an assistive personnel of the opposite gender. C. Three staff members have called to say they will be absent. D. No transport assistance is available to take a client to physical therapy.

Correct Answer is C

Explanation

- A: While resolving conflicts is important to maintain a healthy work environment, it may not immediately affect patient care and safety.
- B: Client preferences should be respected, but this situation can usually be resolved by reassigning staff without immediate risk to patient safety.
- C: Staff absences can critically impact patient care due to inadequate staffing, which can lead to increased workload for present staff and compromise patient care.
- D: Transport issues, although they need to be addressed, do not usually pose an immediate threat to patient safety compared to inadequate staffing. Physical therapy can often be rescheduled without significant harm to the patient.

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A case manager is preparing a discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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