A nurse is caring for a client who just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

Have the client refrain from talking for 24 hr.

Withhold food and liquids until the client's gag reflex returns.

Irrigate the client's throat every 4 hr.

Suction the client's oropharynx frequently.

Answer and Explanation

The Correct Answer is B

A. Have the client refrain from talking for 24 hr.: This is unnecessary; the client may talk once the effects of the local anesthetic wear off, typically within an hour or two after the procedure.
B. Withhold food and liquids until the client's gag reflex returns: This is the most important action to prevent aspiration. After a bronchoscopy, the throat is anesthetized, and eating or drinking before the gag reflex returns increases the risk of aspiration.
C. Irrigate the client's throat every 4 hr.: This is not a routine post-procedure intervention and could be uncomfortable for the client.
D. Suction the client's oropharynx frequently: Suctioning should only be performed if the client has difficulty clearing secretions. There is no routine need for frequent suctioning after a bronchoscopy unless clinically indicated.

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Correct Answer is B

Explanation

A. "Test your blood glucose level every 8 hours.": This is incorrect. During illness, blood glucose levels should be checked more frequently, typically every 2 to 4 hours, to closely monitor for hyperglycemia and prevent diabetic ketoacidosis (DKA). Checking every 8 hours may not be frequent enough, especially if the client is ill or experiencing stress, both of which can affect blood sugar.
B. "Check your urine for ketones when blood glucose levels are greater than 240 mg/dL.": This is the correct instruction. When blood glucose levels exceed 240 mg/dL, it is important to check for ketones in the urine. The presence of ketones can indicate the development of DKA, and early detection can prevent the condition from worsening.
C. "Withhold your usual daily dose of insulin.": This is incorrect. Insulin should never be withheld during periods of illness unless specifically instructed by a healthcare provider. Withholding insulin can increase the risk of DKA, as the body will continue to break down fat for energy in the absence of insulin, leading to ketosis.
D. "Drink 240 to 360 milliliters of calorie-free liquids every 8 hours.": This is not entirely correct. While staying hydrated is important, the recommendation is generally to drink more frequently, ideally 8 ounces of fluid every hour to stay well-hydrated. It is also recommended to drink fluids that contain some carbohydrates (such as electrolyte-containing drinks) to help manage blood glucose levels during illness.

A. Blood glucose 80 mg/dL B. Serum sodium 146 mEq/L C. Blood urea nitrogen (BUN) 15 mg/dL D. Urine specific gravity 1.015

Correct Answer is D

Explanation

A. Blood glucose levels are not directly affected by desmopressin, as it is used to treat diabetes insipidus, which is related to antidiuretic hormone (ADH) deficiency, not glucose metabolism.
B. A serum sodium level of 146 mEq/L is slightly elevated and may indicate dehydration, which is common in diabetes insipidus if not well controlled. Desmopressin should help lower the sodium level by reducing the excessive urine output.
C. Blood urea nitrogen (BUN) is typically used to assess kidney function and hydration status, but it is not a primary indicator of the effectiveness of desmopressin in treating diabetes insipidus.
D. A urine specific gravity of 1.015 is within the normal range and indicates more concentrated urine, which is a therapeutic effect of desmopressin. The medication helps the kidneys retain water, leading to more concentrated urine, and improving symptoms of diabetes insipidus.

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A nurse is caring for a client who just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

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