A client had a laparoscopic bilateral tubal ligation (BTL) in the delivery room. Which intervention should a nurse plan to include in this client’s postoperative care?
Provide the client with an abdominal binder.
Provide a rocking chair at the client’s bedside.
Keep the head of the client’s bed flat for six hours.
Encourage the client to drink cold, carbonated fluids throughout the day.
The Correct Answer is D
The correct answer is choice D. Encourage the client to drink cold, carbonated fluids throughout the day.This helps to relieve the shoulder pain caused by the carbon dioxide gas used to inflate the abdomen during laparoscopy.
The gas irritates the diaphragm, which refers pain to the shoulder. Drinking cold, carbonated fluids can help expel the gas and reduce the pain.
Choice A is wrong because an abdominal binder is not necessary for a laparoscopic procedure. It is more commonly used for abdominal surgeries that involve a large incision.
Choice B is wrong because a rocking chair is not helpful for a client who had a laparoscopic BTL. It is more useful for a client who had a vaginal delivery to promote comfort and uterine involution.
Choice C is wrong because keeping the head of the bed flat for six hours is not indicated for a laparoscopic BTL. It may increase the risk of venous thromboembolism and pulmonary embolism due to prolonged immobility. The client should be encouraged to ambulate as soon as possible after surgery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
This is because a normal fetal heart rate is between 110 and 160 beats per minute, and the range of 136 to 143 indicates that the fetus is well-oxygenated and not experiencing hypoxia or acidosis. The nurse should reassure the patient and explain that fetal movement may decrease during labor due to the pressure of the contractions on the uterus and the fetus.
Choice A is wrong because asking the patient about alcohol consumption is irrelevant and insensitive.
Alcohol can affect fetal development and growth, but it does not directly affect fetal movement or heart rate.
Choice B is wrong because bloody vaginal discharge, or bloody show, is a normal sign of cervical dilation and effacement during labor.
It does not indicate fetal distress or placental abruption.
Choice D is wrong because explaining the relationship between anxiety and fetal movement does not address the patient’s concern or provide any factual information.
Anxiety can affect maternal perception of fetal movement, but it does not cause fetal movement to decrease.
The nurse should validate the patient’s feelings and provide factual reassurance.
Correct Answer is D
Explanation
The correct answer is choice D. Leaning slightly backwards when walking can increase the curvature of the lower spine and worsen back pain.
The other choices are helpful methods to alleviate back pain during pregnancy.
Choice A is correct because pelvic tilt exercises can strengthen the abdominal muscles and reduce the strain on the lower back.
Choice B is correct because wearing shoes with low heels can improve posture and balance and prevent excessive arching of the lower back.
Choice C is correct because sleeping on the side with a pillow beneath the knees can support the spine and pelvis and relieve pressure on the lower back.
Normal ranges for back pain during pregnancy vary depending on the individual, but some common factors that can affect it are weight gain, hormonal changes, center of gravity shift, stress and muscle separation.
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