A nurse is caring client who has peptic ulcer disease and is scheduled to undergo an esophagogastroduodenoscopy. Which of the following actions should the nurse take prior to the procedure?

Ensure that the client gave informed consent

Administer an oral contrast solution.

Inform the client the procedure will take 60 min.

Ensure that the client's bladder is full.

Answer and Explanation

The Correct Answer is A

A) Ensure that the client gave informed consent: Obtaining informed consent is a critical nursing responsibility prior to any procedure, including an esophagogastroduodenoscopy (EGD). The nurse should verify that the client understands the purpose, risks, and potential outcomes of the procedure. This ensures that the client has voluntarily agreed to undergo the procedure after being fully informed.

B) Administer an oral contrast solution: An esophagogastroduodenoscopy (EGD) does not require the administration of an oral contrast solution. The procedure involves the use of a flexible endoscope to visualize the esophagus, stomach, and duodenum, and is typically performed without contrast agents. Oral contrast is more commonly used in imaging studies such as CT scans or fluoroscopy, not in endoscopy.

C) Inform the client the procedure will take 60 min: The duration of an esophagogastroduodenoscopy typically ranges from 15 to 30 minutes, not 60 minutes. The nurse should inform the client about the usual time frame for the procedure, but stating 60 minutes could be an overestimate. Providing accurate information about the length of the procedure helps manage client expectations.

D) Ensure that the client's bladder is full: The procedure is focused on the upper gastrointestinal tract, so bladder fullness is not necessary for an esophagogastroduodenoscopy. The client should be positioned appropriately, usually in a left lateral position, but there is no need for the bladder to be full. The nurse should ensure that the client follows the pre-procedure guidelines, such as fasting, to reduce the risk of complications.

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Correct Answer is C

Explanation

A) Decreased hemoglobin level: A decreased hemoglobin level is not an expected or desirable outcome of taking furosemide. While furosemide can cause fluid loss, it does not directly affect red blood cell production or hemoglobin levels. A decrease in hemoglobin could indicate anemia or another underlying issue, which should be addressed separately.

B) Increased weight of 0.91 kg (2 lb): An increase in weight, especially in a client with heart failure, could indicate fluid retention rather than effective diuresis. Furosemide is a diuretic that helps reduce fluid buildup, so an increase in weight would typically suggest that the medication is not effectively managing fluid overload, which is a key issue in heart failure.

C) Increased urinary output: An increase in urinary output is a clear indicator that furosemide is working effectively. Furosemide is a loop diuretic, which promotes the excretion of sodium and water, leading to increased urine output. This helps reduce fluid volume in the body, which is beneficial for a client with heart failure.

D) Decreased BUN level: While furosemide can affect kidney function, a decrease in blood urea nitrogen (BUN) level is not a direct indicator of the medication’s effectiveness. BUN can be influenced by various factors such as hydration status, kidney function, and protein intake. A decreased BUN level does not directly correlate with furosemide's effectiveness in treating heart failure.

A. Nutritionist B. Case manager C. Primary care provider D. Pediatric nurse practitioner

Correct Answer is B

Explanation

A) Nutritionist:
While a nutritionist can provide valuable advice on feeding, including breastfeeding or formula feeding, the primary issue here is not related to nutritional guidance but rather the financial concern about paying for baby formula. A nutritionist may provide support, but they are not typically responsible for addressing financial needs or coordinating resources for assistance.

B) Case manager:
The case manager is the most appropriate team member to refer to in this situation. A case manager is responsible for assessing the client’s needs and connecting them with resources such as financial assistance, community support programs, or social services. Since the client is unable to afford baby formula, the case manager can help by referring the client to programs that may provide formula at no cost or at a reduced price, such as the Women, Infants, and Children (WIC) program.

C) Primary care provider:
The primary care provider may offer support and referrals but would generally not be the first point of contact for addressing financial barriers to obtaining baby formula. The primary care provider can provide medical advice related to the client's postpartum care and the infant's health, but they are not typically the best person to address financial concerns directly.

D) Pediatric nurse practitioner:
A pediatric nurse practitioner focuses on providing care for the child, not necessarily addressing the financial needs of the family. While they can provide guidance on infant care and feeding, the issue of financial support for formula is outside their role. The case manager would be the more appropriate referral to assist with financial concerns.

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A nurse is caring client who has peptic ulcer disease and is scheduled to undergo an esophagogastroduodenoscopy. Which of the following actions should the nurse take prior to the procedure?

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