A nurse is admitting a client who is to undergo paracentesis for removal of ascitic fluid. Which of the following actions should the nurse take?

Weigh the client before and after the procedure.

Administer a low-volume hypertonic enema the night before the procedure.

Ensure the client has a full bladder just prior to the procedure.

Place the client in a side-lying position for the procedure.

Answer and Explanation

The Correct Answer is A

A. Weigh the client before and after the procedure: Monitoring the client’s weight before and after paracentesis provides an objective measure of the volume of fluid removed. This helps evaluate the effectiveness of the procedure and assess for complications such as fluid shifts or hypotension.

B. Administer a low-volume hypertonic enema the night before the procedure: Bowel cleansing is not required for paracentesis, as the procedure targets the peritoneal cavity, not the gastrointestinal tract. Administering an enema could cause unnecessary discomfort without benefit.

C. Ensure the client has a full bladder just prior to the procedure: A full bladder increases the risk of puncture during paracentesis. Clients are typically advised to void before the procedure to minimize the risk of bladder injury.

D. Place the client in a side-lying position for the procedure: Paracentesis is usually performed with the client in a sitting position, leaning slightly forward, or in a supine position with the head of the bed elevated. Side-lying positioning does not provide optimal access to the fluid-filled peritoneal cavity.

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Correct Answer is C

Explanation

A. Have the client store smaller tanks under his bed: Storing oxygen tanks under the bed poses a serious fire hazard and increases the risk of accidental tipping or damage. Proper storage requires a stable, upright position in a well-ventilated area away from flammable materials.

B. Ensure that the client checks the gauge weekly: Oxygen tanks should be checked daily to ensure adequate supply and to prevent sudden depletion. Waiting a week between checks could result in unexpected oxygen interruption, which is unsafe for clients dependent on supplemental oxygen.

C. Place the oxygen tank away from curtains or drapes: Oxygen supports combustion, and placing tanks near flammable materials such as curtains, drapes, or open flames increases the risk of fire. Proper placement in a clear, ventilated area is a critical safety measure for home oxygen therapy.

D. Store the oxygen tank wrench in a locked cabinet: While securing equipment is generally safe, the oxygen tank wrench must be readily accessible in case of emergency or the need to quickly turn off the oxygen. Locking it away could delay urgent intervention.

A. Aspirin 1 tablet daily B. Metoprolol 5 mg IV now C. Nitroglycerin transdermal patch D. Furosemide 20 mg BID

Correct Answer is B

Explanation

A. Aspirin 1 tablet daily: This prescription is incomplete because it does not specify the dosage strength (e.g., 81 mg or 325 mg). Without the strength, safe administration cannot be ensured.

B. Metoprolol 5 mg IV now: This prescription is complete because it includes the medication name, exact dosage, route of administration, and timing (“now”), providing all necessary information for safe administration.

C. Nitroglycerin transdermal patch: This prescription is incomplete as it does not specify the dosage strength (e.g., 0.1 mg/hr), location of application, or timing, which are necessary for safe and effective use.

D. Furosemide 20 mg BID: This prescription is incomplete because it does not specify the route of administration (oral or IV), which is essential for safe administration and proper monitoring of effects.

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A nurse is admitting a client who is to undergo paracentesis for removal of ascitic fluid. Which of the following actions should the nurse take?

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