A nurse is caring for a client who is 9 days postoperative following a total laryngectomy. The nurse removes the client's NG tube and initiates oral feedings. Which of the following statements should the nurse make?

"Tuck your chin when you swallow so you won't choke."

"You should have no trouble swallowing fluids."

"I will add a thickener to your liquids to prevent aspiration."

"It is no longer possible for you to choke on or aspirate food."

Answer and Explanation

The Correct Answer is C

A. Tucking the chin when swallowing can help reduce the risk of aspiration in clients with certain conditions, but after a total laryngectomy, clients are at increased risk for aspiration due to altered anatomy and should have thickened liquids to minimize this risk.

B. Clients who have undergone a total laryngectomy may have difficulties with swallowing and are at risk of aspiration. It is not accurate to say they will have no trouble swallowing fluids without proper assessment and adaptation.

C. Adding a thickener to liquids is a recommended intervention to reduce the risk of aspiration in clients who have had a laryngectomy, as thickened fluids are less likely to be aspirated into the lungs compared to thin liquids.

D. Clients who have had a total laryngectomy are still at risk for choking or aspiration due to changes in their swallowing mechanics and altered anatomy. It is important to take preventive measures, such as thickening liquids.

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Correct Answer is D

Explanation

A. An arteriovenous fistula is used for dialysis, not for long-term antibiotic therapy.
B. An implanted infusion port is suitable for long-term therapy but is typically used for medications that require infusions over weeks or months rather than prolonged IV therapy.
C. A short peripheral catheter is not appropriate for extended therapy due to the risk of thrombophlebitis and infiltration.
D. A peripherally inserted central catheter (PICC) is appropriate for long-term intravenous antibiotic therapy as it provides reliable access and reduces the risk of complications associated with extended peripheral catheter use.

A. The client's bladder becomes distended. B. The client's blood pressure becomes elevated. C. The client states having nasal congestion. D. The client states having a severe headache.

Correct Answer is A

Explanation

A. Bladder distension is a common trigger for autonomic dysreflexia in individuals with spinal cord injuries above T-6. It is crucial to manage bladder function to prevent this potentially life-threatening condition.

B. Elevated blood pressure is a sign of autonomic dysreflexia rather than a predisposing factor. Identifying the trigger, such as bladder distension, is essential before addressing the elevated blood pressure.

C. Nasal congestion is not typically associated with autonomic dysreflexia. While it might be uncomfortable, it is not a common trigger for this condition.

D. A severe headache can be a symptom of autonomic dysreflexia, but identifying the underlying cause or trigger, such as bladder distension, is essential for proper management.

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A nurse is caring for a client who is 9 days postoperative following a total laryngectomy. The nurse removes the client's NG tube and initiates oral feedings. Which of the following statements should the nurse make?

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