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) Client report of muscle spasms of the left leg: Muscle spasms are common in clients with a cast, especially if the muscle is restricted for an extended period. While muscle spasms can be uncomfortable, they are not immediately life-threatening. The nurse should still address the discomfort but it does not take priority over other potential issues like circulation.
B) One fingerbreadth of space between the cast and the skin: A small amount of space between the cast and the skin can be normal and is typically observed in a well-applied cast. However, this finding alone does not indicate an immediate concern unless other signs such as swelling or impaired circulation are noted.

C) Diminished pulses on the affected extremity: Diminished pulses are a priority concern. This may indicate compromised circulation, which can lead to serious complications such as tissue ischemia or compartment syndrome. The nurse should immediately assess the severity of the circulation problem, as any signs of compromised blood flow require prompt intervention to prevent permanent damage or loss of limb function.

D) Ecchymosis on the inner left thigh: Ecchymosis or bruising on the inner thigh can be a normal consequence of trauma or injury related to the reason for the cast. While it is important to monitor for any changes in the condition, ecchymosis itself is not immediately life-threatening or urgent compared to potential circulation issues.

A. Put small cushion under the newborn's head for support. B. Position the car seat at a 90° angle. C. Place the shoulder harnesses at the level of the infant's shoulders. D. Keep the airbag on if the car seat is in the front seat.

Correct Answer is C

Explanation

A) "Put small cushion under the newborn's head for support.":
This statement is incorrect. Placing a small cushion or any additional padding under a newborn’s head in a car seat is not recommended. Extra padding can interfere with the proper fit of the harness and could pose a safety risk in the event of a crash. The car seat should be used as designed, without extra padding that could affect the infant's positioning.

B) "Position the car seat at a 90° angle.":
This statement is incorrect. The car seat should be positioned at a 45-degree angle, not 90 degrees. A 45-degree angle helps prevent the infant’s head from falling forward, which can obstruct the airway and cause breathing difficulties. Positioning the seat at the correct angle ensures that the baby’s head and neck are properly supported.

C) "Place the shoulder harnesses at the level of the infant's shoulders.":
This statement is correct. For optimal safety, the shoulder harness straps should be at or just below the infant's shoulders when they are in a rear-facing car seat. This positioning helps to keep the baby secure and ensures the harness fits properly in the event of an accident. The harness should be snug and positioned correctly to provide the best protection.

D) "Keep the airbag on if the car seat is in the front seat.":
This statement is incorrect. It is recommended that infants and young children always be placed in a rear-facing car seat in the back seat of the vehicle, as this is the safest position. Airbags can be dangerous to infants if the car seat is in the front seat. If the car seat must be placed in the front seat (which is not recommended), the airbag should be turned off to prevent injury in the event of a crash.

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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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