A nurse is planning care for a client who is returning to the unit following open gastric bypass surgery. Which of the following interventions should the nurse include in the client's plan of care?

Ambulate the client 48 hr after the procedure.

Provide a soft diet on the first postoperative day.

Provide 60 mL (2 oz) of fluid intake every 5 min.

Measure and compare abdominal girth daily.

Answer and Explanation

The Correct Answer is D

A) Ambulate the client 48 hr after the procedure: Early ambulation is important to prevent complications such as deep vein thrombosis and promote recovery. However, ambulating the client 48 hours after the procedure may be too late. Early mobilization, usually within the first 24 hours, is encouraged.

B) Provide a soft diet on the first postoperative day: After gastric bypass surgery, the client typically starts with clear liquids and gradually progresses to a soft diet. Providing a soft diet on the first postoperative day is not appropriate and could cause complications.

C) Provide 60 mL (2 oz) of fluid intake every 5 min: Fluid intake should be carefully monitored and gradually increased. Providing 60 mL of fluid every 5 minutes is excessive and could lead to discomfort or complications such as dumping syndrome.

D) Measure and compare abdominal girth daily: Measuring and comparing abdominal girth daily helps monitor for signs of complications such as internal bleeding or anastomotic leaks. This intervention is crucial for early detection and prompt management of potential issues

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Correct Answer is D

Explanation

A) Increased calcium levels are typically not expected in clients with chronic kidney disease (CKD). In fact, CKD often leads to decreased calcium levels due to impaired renal function, which affects vitamin D metabolism and calcium absorption.

B) Increased bicarbonate levels would suggest a metabolic alkalosis, which is not common in CKD. Clients with CKD often experience metabolic acidosis due to the kidneys' inability to excrete hydrogen ions effectively, leading to decreased bicarbonate levels.

C) Increased hemoglobin levels are not expected in CKD; rather, clients often experience anemia due to decreased erythropoietin production by the kidneys. Therefore, hemoglobin levels are typically low in individuals with chronic kidney disease.

D) Increased creatinine is a hallmark finding in chronic kidney disease. It indicates a decline in kidney function, as creatinine is a waste product that is normally excreted by the kidneys. Elevated creatinine levels reflect the kidneys' reduced ability to filter and excrete waste, which is characteristic of CKD.

A. "Limit your child's potassium intake while she is taking this medication." B. “Repeat the dose if your child vomits within 1 hour after taking the medication." C. "Have your child drink a small glass of water after swallowing the medication." D. "You can add the medication to a half-cup of your child's favorite juice."

Correct Answer is C

Explanation

A. "Limit your child's potassium intake while she is taking this medication.": This statement is incorrect. In fact, potassium intake should generally be adequate because digoxin can lead to increased potassium loss, and low potassium levels can increase the risk of digoxin toxicity.

B. “Repeat the dose if your child vomits within 1 hour after taking the medication.": This statement is not recommended. The nurse should advise parents to contact their healthcare provider for guidance on whether to administer a repeat dose after vomiting, as it depends on the individual situation and timing.

C. "Have your child drink a small glass of water after swallowing the medication.": This statement is appropriate as it can help ensure that the medication is swallowed properly and aids in its absorption. Adequate hydration is important for all medications.

D. "You can add the medication to a half-cup of your child's favorite juice.": This is not advisable because mixing digoxin with juice can alter the absorption of the medication. It's generally better to administer it alone to ensure proper dosing and effectiveness.

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A nurse is planning care for a client who is returning to the unit following open gastric bypass surgery. Which of the following interventions should the nurse include in the client's plan of care?

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