A nurse is caring for a client who has end-stage liver disease and is undergoing a paracentesis. Which of the following actions should the nurse take to evaluate the effectiveness of the procedure?
Confirm that the client is able to urinate.
Check the client's serum albumin levels.
Compare the client's current weight with preprocedure weight.
Examine for leakage at the site of the procedure.
The Correct Answer is C
A. Incorrect. Urination is not directly related to the evaluation of the effectiveness of a paracentesis procedure.
B. Incorrect. Checking serum albumin levels may be important in managing ascites, but it is not a direct measure of the immediate effectiveness of the paracentesis.
C. Correct. Monitoring the client's weight is a common way to assess the effectiveness of a paracentesis, as the procedure aims to remove excess abdominal fluid (ascites), which can lead to a reduction in body weight.
D. Incorrect. Examining for leakage at the site of the procedure is important for safety but does not directly reflect the effectiveness of the paracentesis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. A filter needle should be used to withdraw medication from an ampule to prevent drawing up any glass fragments into the syringe.
B. Using the same needle to draw up and inject the client is not recommended to prevent contamination.
C. Breaking the neck of the ampule toward the body is not a safe practice, as it can cause injury.
D. Ampules should be disposed of properly in a sharps container, not a regular trash can.
Correct Answer is C
Explanation
A. Incorrect. It's important to alternate breasts during feedings to ensure both breasts are stimulated and milk supply is well-maintained.
B. Incorrect. Manually expressing milk can help stimulate milk production and maintain milk supply; it typically does not decrease milk supply.
C. Correct. Frequent and effective breastfeeding, along with proper latching and milk removal, stimulates the production of more milk.
D. Incorrect. Breastfeeding should continue for as long as the baby is actively sucking and swallowing. Babies vary in their feeding patterns, and the length of time at each breast can differ. It's essential to ensure the baby is adequately fed and empties the breast to stimulate milk supply.
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