A nurse is caring for a client who is 12 hr postoperative following a below-the-knee amputation. Which of the following interventions should the nurse implement?

Turn the client every 4 hr while in bed.

Place the client on an air mattress.

Instruct the client to use an overbed trapeze to move around in bed.

Rewrap the bandage every 8 hr in a circular pattern.

Answer and Explanation

The Correct Answer is C

A. Turning the client every 4 hours is too infrequent for a postoperative patient. The client should be turned at least every 2 hours to prevent complications such as pressure injuries.
B. An air mattress may help prevent pressure ulcers, but it does not specifically address postoperative care for an amputation.
C. Using an overbed trapeze allows the client to move independently, reducing strain on the residual limb and promoting mobility while preventing pressure injuries.
D. The bandage should be rewrapped every 4 to 6 hours in a figure-eight pattern, not every 8 hours in a circular pattern, to promote proper shaping of the residual limb and prevent circulation issues.

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Correct Answer is A

Explanation

A. "I can use chamomile tea to promote sleep." Chamomile has calming properties and is commonly used as a natural remedy to promote relaxation and improve sleep.
B. "Herbal medicines do not interact with conventional medications." Many herbs can interact with prescription medications, potentially causing harmful effects.
C. "I can use ginger to help treat headaches." Ginger is primarily used to reduce nausea and motion sickness rather than for headache relief.
D. "Herbal medicines are regulated by the Food and Drug Administration." Herbal supplements are not regulated by the FDA in the same way as prescription and over-the-counter medications.

A. Antibiotic therapy B. Protective environment C. Blood transfusion D. Iron supplementation

Correct Answer is D

Explanation

A. Antibiotic therapy. This is incorrect because there is no indication of an infection. The WBC count is within the normal range, and there are no symptoms suggestive of a bacterial infection.
B. Protective environment. This is incorrect because a protective environment is used for immunocompromised clients, such as those undergoing chemotherapy or with severe neutropenia, which is not the case here.
C. Blood transfusion. This is incorrect because although the hemoglobin level is low (8.1 g/dL), it is not critically low enough to require a transfusion. Instead, iron supplementation is the preferred treatment.
D. Iron supplementation. This is correct because the child’s hemoglobin and hematocrit levels indicate mild anemia, likely due to excessive cow’s milk intake, which can lead to iron deficiency anemia in toddlers. Iron supplementation will help correct the deficiency.

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A nurse is caring for a client who is 12 hr postoperative following a below-the-knee amputation. Which of the following interventions should the nurse implement?

Nursing Test Bank

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