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 A

Explanation

A) Preoccupied with aging: Individuals with narcissistic personality disorder often have an intense focus on their appearance and status, which can lead to preoccupation with aging. They may fear losing their attractiveness and the admiration they receive, making this a common finding during assessment.

B) Suspicious of others: Suspiciousness is more characteristic of paranoid personality disorder. While individuals with narcissistic personality disorder may have difficulties in relationships, they are not typically driven by suspicion; rather, they may have an inflated sense of self-importance and entitlement.

C) Exhibits separation anxiety: Separation anxiety is generally not associated with narcissistic personality disorder. Clients with this disorder often exhibit self-sufficiency and may not show signs of dependency that would lead to separation anxiety.

D) Ritualistic behavior: Ritualistic behaviors are more indicative of obsessive-compulsive disorder or obsessive-compulsive personality disorder. Narcissistic personality disorder is focused on self-importance and seeking admiration rather than engaging in specific rituals or compulsions.

A. "Do you need information on hospice care?" B. "Do you need a prescription for an antianxiety medication?" C. "Would you like to talk to a counselor about advance directives?" D. "Would you like to speak to a spiritual advisor?"

Correct Answer is D

Explanation

A. "Do you need information on hospice care?" While hospice care is important for terminally ill patients, this question may not directly address the client's feelings of depression or their immediate emotional needs.

B. "Do you need a prescription for an antianxiety medication?" This statement may not be appropriate at this time, as it suggests a focus on medication rather than exploring the client's feelings. It’s important to first assess the client’s emotional needs and discuss therapy options.

C. "Would you like to talk to a counsellor about advance directives?" This question shifts the focus from the client's feelings of depression to advance care planning, which may not be the most relevant topic at this moment.

D. "Would you like to speak to a spiritual advisor?" This statement acknowledges the client's emotional state and offers a supportive option for exploring feelings of depression, which can be beneficial for those facing terminal illness. Spiritual support can provide comfort and help the client process their emotions during this difficult time.

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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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