A nurse in the postanesthesia care unit is caring for four postoperative clients. The nurse realizes that coughing poses a risk to which of the following clients?

A client who had an emergency appendectomy

A client who had a vaginal hysterectomy

A client who had a thyroidectomy

A client who had cataract removal

Answer and Explanation

The Correct Answer is C

A. A client who had an emergency appendectomy: While coughing can cause some discomfort at the abdominal incision site, it generally does not pose a high risk of serious complications if the client uses proper splinting techniques.

B. A client who had a vaginal hysterectomy: Coughing may cause mild discomfort or stress on the pelvic floor, but it is not typically associated with significant risk if the client follows postoperative instructions and uses support as needed.

C. A client who had a thyroidectomy: Coughing after a thyroidectomy can place stress on the surgical site in the neck, increasing the risk of bleeding, airway compromise, or wound dehiscence. This makes coughing a particular concern for immediate postoperative safety and monitoring.

D. A client who had cataract removal: Coughing does not pose a risk to the eye or surgical site following cataract surgery. Clients may be advised to avoid straining, but coughing is generally safe and not a priority concern.

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Correct Answer is C

Explanation

A. Assist the client to a supine position: There is no requirement to maintain a supine position for bacterial meningitis. Clients are often more comfortable with the head of the bed elevated to reduce intracranial pressure and promote comfort. Supine positioning alone does not prevent disease transmission or improve outcomes.

B. Recommend prophylactic acyclovir for the client's family: Acyclovir is an antiviral medication and is not effective against bacterial infections. Family members may require prophylactic antibiotics if exposed, but antiviral therapy is inappropriate for bacterial meningitis.

C. Initiate droplet precautions for the client: Bacterial meningitis, particularly Neisseria meningitidis, can be transmitted via respiratory droplets. Implementing droplet precautions, including the use of masks and limiting close contact, protects healthcare staff and other clients from infection. This is a standard and critical infection control measure.

D. Perform a Glasgow Coma Scale every 24 hr: Clients with bacterial meningitis are at risk for rapid neurological changes. Performing a Glasgow Coma Scale only once every 24 hours is insufficient. Neurological status should be monitored more frequently to promptly identify deterioration.

A. Levothyroxine for hypothyroidism B. Phenytoin for seizure disorder C. Magnesium oxide for constipation D. Ferrous sulfate for chronic anemia

Correct Answer is B

Explanation

A. Levothyroxine for hypothyroidism: Levothyroxine is a thyroid hormone replacement that is considered safe in pregnancy. Proper management of maternal hypothyroidism is essential for fetal neurodevelopment, and it does not pose teratogenic risk.

B. Phenytoin for seizure disorder: Phenytoin is an antiepileptic drug associated with fetal hydantoin syndrome, which can cause congenital malformations such as cleft lip, cardiac defects, and skeletal abnormalities. It carries a known risk for teratogenic effects, requiring careful monitoring and potential consideration of alternative therapies.

C. Magnesium oxide for constipation: Magnesium oxide is generally safe for use during pregnancy for the treatment of constipation. It does not have teratogenic effects and is considered appropriate for maternal use when needed.

D. Ferrous sulfate for chronic anemia: Iron supplementation is essential in pregnancy to prevent maternal anemia and support fetal growth. Ferrous sulfate is safe and does not cause congenital malformations, making it an appropriate therapy during pregnancy.

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A nurse in the postanesthesia care unit is caring for four postoperative clients. The nurse realizes that coughing poses a risk to which of the following clients?

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