A nurse is preparing a plan of care for a client who is postoperative following a cochlear implant insertion. Which of the following instructions should the nurse include in the plan of care?
Lie on your back when sleeping.
Lie on your front when sleeping.
Resume your exercise routine.
Wash your hair 24 hr after surgery.
The Correct Answer is D
A. Lie on your back when sleeping: Lying on the back when sleeping may be recommended initially after cochlear implant surgery to avoid putting pressure on the surgical site. However, this instruction should not be included in the plan of care indefinitely. Once the client is comfortable and the surgical site is healing well, they should be allowed to sleep in any position that is comfortable for them.
B. Lie on your front when sleeping: Lying on the front when sleeping is not typically recommended after cochlear implant surgery, as it may put pressure on the surgical site and disrupt healing. This position could potentially cause discomfort and increase the risk of complications. Therefore, this instruction should not be included in the plan of care.
C. Resume your exercise routine: Resuming the exercise routine immediately after cochlear implant surgery may not be advisable. The client should be instructed to avoid strenuous activities and heavy lifting for a certain period as advised by the healthcare provider. Engaging in vigorous exercise too soon after surgery could potentially disrupt the healing process and increase the risk of complications. Therefore, this instruction should not be included in the plan of care immediately after surgery.
D. Wash your hair 24 hr after surgery: After cochlear implant insertion, it is important to keep the surgical site clean to prevent infection. Washing the hair 24 hours after surgery helps to maintain cleanliness and hygiene without disrupting the surgical site. It is typically safe to wash the hair after this period as long as gentle care is taken to avoid excessive manipulation of the implant site.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "I should ask my son to drive me to the grocery store." This statement does not directly address the risk for sudden cardiac death associated with arrhythmogenic cardiomyopathy. While it may be a valid safety precaution to have someone else drive, it does not specifically address the client's understanding of the condition and its implications for sudden cardiac death.
B. "I will probably become easily constipated." Constipation is not a typical manifestation or complication of arrhythmogenic cardiomyopathy. This statement does not demonstrate an understanding of the condition and its associated risk of sudden cardiac death.
C. "I am aware that I may develop frequent hiccups." Frequent hiccups are not a characteristic symptom or complication of arrhythmogenic cardiomyopathy. This statement does not indicate an understanding of the condition and its risk for sudden cardiac death.
D. "I will need to avoid strenuous activity to prevent my heart from stopping." This statement reflects an understanding of the condition and its associated risk of sudden cardiac death. Strenuous activity can exacerbate arrhythmias in individuals with arrhythmogenic cardiomyopathy, potentially leading to life-threatening arrhythmias such as ventricular fibrillation. Avoiding strenuous activity is a recommended precaution to reduce the risk of sudden cardiac death in individuals with this condition.
Correct Answer is A
Explanation
A. Lower back or groin pain: Lower back or groin pain can be an early manifestation of an abdominal aortic aneurysm (AAA). This pain may result from pressure exerted by the enlarging aneurysm on surrounding structures or from irritation of nerves as the aneurysm expands. As the aneurysm enlarges, the pain may become more severe and persistent.
B. Hunger after eating: Hunger after eating is not typically associated with an abdominal aortic aneurysm. This symptom may be indicative of various gastrointestinal issues such as peptic ulcer disease or gastritis, but it is not a characteristic manifestation of AAA.
C. Pain in the chest: While AAA can lead to compression of nearby structures, resulting in referred pain, chest pain is not a common early manifestation of an abdominal aortic aneurysm. Chest pain is more commonly associated with cardiac issues such as angina or myocardial infarction.
D. Presence of Cullen's sign: Cullen's sign refers to periumbilical bruising, which can occur due to retroperitoneal hemorrhage from a ruptured AAA. However, Cullen's sign is not an early manifestation of an AAA; it is typically observed in more advanced cases or after rupture has occurred.
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