A nurse is planning a teaching session about hysterosalpingography for a client who has a diagnosis of infertility. The nurse should include which of the following information in the teaching plan?

The client should anticipate scheduling the procedure 5 days prior to menstruation.

The client might experience diarrhea as a result of the procedure.

The client should be on a liquid diet for 1 day following the procedure.

The client might experience shoulder pain following the procedure.

Answer and Explanation

The Correct Answer is D

Choice A reason:Scheduling the procedure five days before the expected menses would place it in the late proliferative phase, which risks missing ongoing menstrual bleeding and could coincide with implantation if the client ovulated early. Best practice is to perform the test after menstruation ends but before ovulation—usually within 12 days of the first day of the last period—to ensure the client is not pregnant.

Choice B reason:
Diarrhea is not a common side effect of HSG. The procedure involves the insertion of a dye into the uterine cavity to visualize the fallopian tubes and uterus via X-ray. While some discomfort, cramping, or spotting may occur, diarrhea is not typically expected.

Choice C reason:
There is no requirement for a client to be on a liquid diet following an HSG procedure. The client can usually resume normal activities and diet immediately after the procedure unless otherwise instructed by their healthcare provider.

Choice D reason:
Referred shoulder pain can occur when contrast fluid spills through a patent tube into the peritoneal cavity, irritating the diaphragm’s undersurface and eliciting pain perceived at the shoulder via the phrenic nerve. Clients should be advised this is normal, short-lived, and relieved by positioning or mild analgesics.

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Correct Answer is ["B","C","E"]

Explanation

Choice A reason:
Increased hematocrit levels are not typically associated with fluid overload. In fact, hematocrit may decrease in fluid overload due to hemodilution, where the volume of plasma increases, diluting the concentration of red blood cells.

Choice B reason:
An increased respiratory rate can be a sign of fluid overload. As fluid accumulates in the body, it can lead to pulmonary edema, which is the buildup of fluid in the lung's air sacs. This can impair gas exchange and lead to increased respiratory rate as the body attempts to compensate for reduced oxygenation.

Choice C reason:
Increased blood pressure is a common finding in fluid overload. As the volume of fluid in the bloodstream increases, it can lead to higher blood pressure due to the extra fluid that the heart must pump and the increased resistance in the blood vessels.

Choice D reason:
Increased temperature is not a direct finding associated with fluid overload. While fever may indicate an infection or other conditions, it is not specifically related to the volume of fluid in the body.

Choice E reason:
An increased heart rate may occur in fluid overload as the heart works harder to pump the excess volume of blood through the body. This compensatory mechanism aims to maintain adequate circulation and blood pressure despite the increased fluid volume.

A. pH 7.50, HCO₃⁻ 20 mEq/L, PaCO₂ 32 mm Hg B. pH 7.25, HCO₃⁻ 19 mEq/L, PaCO₂ 30 mm Hg C. pH 7.30, HCO₃⁻ 26 mEq/L, PaCO₂ 50 mm Hg D. pH 7.55, HCO₃⁻ 30 mEq/L, PaCO₂ 31 mm Hg

Correct Answer is B

Explanation

Choice A reason:
This choice suggests a pH of 7.50, which is indicative of alkalosis, and not typically expected in a client with chronic kidney disease (CKD). CKD often leads to metabolic acidosis due to the accumulation of acids in the body as the kidneys fail to excrete them. The HCO₃⁻ level of 20 mEq/L is slightly lower than the normal range (22-26 mEq/L), and the PaCO₂ of 32 mm Hg is within the normal range (35-45 mm Hg), but these values do not align with the expected acidosis associated with CKD.

Choice B reason:
This set of values is consistent with metabolic acidosis, which is commonly seen in clients with CKD. A pH of 7.25 indicates acidemia, and an HCO₃⁻ level of 19 mEq/L is below the normal range, suggesting a primary metabolic acidosis. The PaCO₂ of 30 mm Hg is at the lower end of the normal range, which may indicate a compensatory respiratory response to the metabolic acidosis.

Choice C reason:
A pH of 7.30, while on the lower side, is not as acidic as one would expect in a client with CKD. The HCO₃⁻ level of 26 mEq/L is within the normal range, and a PaCO₂ of 50 mm Hg suggests respiratory acidosis, which is not the primary disorder in CKD.

Choice D reason:
This choice indicates a pH of 7.55, which is too alkaline and not characteristic of CKD, where metabolic acidosis is the expected finding. An HCO₃⁻ level of 30 mEq/L is higher than the normal range, suggesting metabolic alkalosis. The PaCO₂ of 31 mm Hg is slightly below the normal range, possibly indicating a compensatory response, but it does not align with the metabolic acidosis typically seen in CKD.

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A nurse is planning a teaching session about hysterosalpingography for a client who has a diagnosis of infertility. The nurse should include which of the following information in the teaching plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["B","C","E"]

Explanation

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Correct Answer is B

Explanation

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