A nurse is planning care for a client who is postoperative following creation of an arteriovenous fistula in the left arm. Which of the following actions should the nurse include in the plan?

Auscultate the client's left arm for a bruit every 4 hours.

Compare blood pressure in both arms every 2 hours.

Instruct the client to keep the left arm in a dependent position.

Encourage the client to restrict movement of the left arm.

Answer and Explanation

The Correct Answer is A

A. Auscultating the client's left arm for a bruit helps assess the patency and function of the arteriovenous fistula. A bruit indicates normal blood flow through the fistula.

B. Comparing blood pressure in both arms every 2 hours is not specifically related to monitoring the arteriovenous fistula. Blood pressure comparison may be done periodically but is not as directly relevant to postoperative care of the fistula.

C. Instructing the client to keep the left arm in a dependent position may help with venous return but is not the primary action for monitoring the arteriovenous fistula's patency and function.

D. Encouraging the client to restrict movement of the left arm is not necessary unless there are specific instructions from the surgeon. Encouraging gentle movement and range of motion exercises may actually be beneficial for preventing stiffness and promoting healing.

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Correct Answer is C

Explanation

A. "Limit your meals to three times per day." - Incorrect. Following gastric bypass surgery,

clients are typically advised to eat small, frequent meals rather than limiting to three large meals per day.

B. "Consume at least 25 grams of fiber daily." - Incorrect. While fiber is important for gastrointestinal health, clients following gastric bypass surgery may need to avoid high-fiber foods initially and gradually reintroduce them based on individual tolerance.

C. "Start each meal with a protein source." - Correct. Protein is essential for wound healing and maintenance of muscle mass after gastric bypass surgery. Starting each meal with a protein source helps ensure an adequate intake.

D. "Check your blood glucose level before each meal." - This instruction is not directly related to dietary management following gastric bypass surgery. Blood glucose monitoring may be necessary for clients with diabetes, but it is not specific to post-gastric bypass dietary

instructions.

A. "Include the complete name of the medication morphine sulfate." B. "Do not use a leading zero prior to a decimal point." C. "Write the letter U when noting the dosage of insulin." D. "Use the abbreviation QOD when indicating every other day."

Correct Answer is A

Explanation

A. It's important to include the complete name of the medication to ensure clarity and accuracy in documentation.

B. Omitting the leading zero before a decimal point can lead to medication errors, so it's important to include it.

C. "U" is commonly used to denote units when documenting insulin dosage, so this statement is accurate.

D. "QOD" is an outdated abbreviation and can lead to confusion, so it should not be used; instead, "every other day" should be written out for clarity.

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A nurse is planning care for a client who is postoperative following creation of an arteriovenous fistula in the left arm. Which of the following actions should the nurse include in the plan?

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