A nurse is preparing a client who has advanced cirrhosis for an abdominal paracentesis. Which of the following actions should the nurse take?

Place the client on his back.

Have the client increase ﬂuid intake after the procedure.

Assure the client that the procedure is painless.

Instruct the client to empty his bladder.

Answer and Explanation

The Correct Answer is D

Choice A: Place the client on his back. This is incorrect because the client should be placed in a sitting position with the head of the bed elevated to 30 to 45 degrees. This allows the ﬂuid to accumulate in the lower abdomen and reduces the risk of puncturing the diaphragm.

Choice B: Have the client increase ﬂuid intake after the procedure. This is also incorrect because the client should restrict ﬂuid intake after the procedure to prevent ﬂuid overload and electrolyte imbalance. The nurse should monitor the client’s intake and output, weight, and vital signs.

Choice C: Assure the client that the procedure is painless. This is not true because the client may experience some discomfort or pressure during the insertion of the needle or catheter. The nurse should administer analgesics as prescribed and provide emotional support.

Choice D: Instruct the client to empty his bladder. This is correct because this reduces the risk of bladder injury during the procedure. The nurse should also measure and record the amount of urine voided.

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Correct Answer is C

Explanation

Choice A reason: This test does not detect antithyroid antibodies in your blood. Antithyroid antibodies are proteins that atack the thyroid gland and can cause autoimmune thyroid diseases, such as Hashimoto’s thyroiditis or Graves’ disease. To detect antithyroid antibodies, you need a diﬀerent blood test called the thyroid peroxidase (TPO) antibody test.

Choice B reason: This test does not measure the amount of thyroid hormone that ataches to a protein in your blood. Thyroid hormone can exist in two forms in the blood: free or bound. Free thyroid hormone is not atached to any protein and can enter the cells and tissues where it is needed. Bound thyroid hormone is atached to a protein called thyroxine-binding globulin (TBG) and cannot enter the cells and tissues. To measure the amount of thyroid hormone that ataches to TBG, you need a diﬀerent blood test called the total thyroxine (T4) test.

Choice C reason: This test determines whether your thyroid gland is overactive, appropriately active, or underactive. TSH is a hormone produced by the pituitary gland that stimulates the thyroid gland to make and release thyroid hormones, such as thyroxine (T4) and triiodothyronine (T3). These hormones regulate many body functions, such as metabolism, growth, and development. The TSH test measures the amount of TSH in the blood and reﬂects how well the thyroid gland is working. If the TSH level is high, it means that the thyroid gland is underactive (hypothyroidism) and not making enough thyroid hormones. If the TSH level is low, it means that the thyroid gland is overactive (hyperthyroidism) and making too much thyroid hormones.

Choice D reason: This test does not measure the absorption of iodine and how it relates to the thyroid gland. Iodine is a mineral that is essential for the production of thyroid hormones. The thyroid gland absorbs iodine from the food and water we consume and uses it to make T4 and T3. To measure the absorption of iodine by the thyroid gland, you need a diﬀerent test called the radioactive iodine uptake (RAIU) test.

A. “Wear closed-toed shoes daily.” B. “Maintain stable blood glucose levels.” C. “Plan to have an eye examination once per year.” D. “Examine your feet carefully every day.”

Correct Answer is B

Explanation

Choice A reason: Wearing closed-toed shoes daily is a good practice for people with diabetes, as it can protect the feet from injuries and infections. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. These complications are mainly caused by high blood glucose levels that damage the blood vessels and nerves in the eyes and feet.

Choice B reason: Maintaining stable blood glucose levels is the most important action for preventing long-term complications of retinopathy and neuropathy. High blood glucose levels can cause oxidative stress, inﬂammation, and endothelial dysfunction, which impair the blood ﬂow and oxygen delivery to the eyes and feet. This can lead to nerve damage (neuropathy) and vision loss (retinopathy) over time. Keeping blood glucose levels within the target range can reduce the risk of these complications and slow down their progression if they already exist.

Choice C reason: Planning to have an eye examination once per year is a recommended action for people with diabetes, as it can help detect and treat retinopathy before it causes irreversible damage to the retina. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. Eye examinations cannot prevent retinopathy from occurring or worsening; they can only monitor its status and provide appropriate interventions.

Choice D reason: Examining your feet carefully every day is another recommended action for people with diabetes, as it can help identify and treat any signs of neuropathy, such as numbness, tingling, pain, or ulcers. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. Foot examinations cannot prevent neuropathy from occurring or worsening; they can only monitor its status and provide appropriate care.

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A nurse is preparing a client who has advanced cirrhosis for an abdominal paracentesis. Which of the following actions should the nurse take?

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