A nurse is providing discharge education to a client who has undergone extracapsular cataract extraction surgery. What should the nurse include in the discharge teaching? (Select all that apply.)

Wash your hands before administering your eye drops.

It is likely that cataracts will grow back on the implanted lens.

Bend at the waist if you need to reach something on the ground.

You will need to come back in 14 days to have the sutures removed.

Wear the shield at night until you are cleared by the physician.

Answer and Explanation

Correct Answer : A,E

A.   Proper hand hygiene is critical to prevent introducing infections into the eye, especially after eye surgery. The client should always wash their hands before touching their eyes or administering any eye drops to maintain sterility and reduce the risk of infection.
B.   After extracapsular cataract extraction, the cataract itself does not grow back on the implanted lens. However, a condition called posterior capsule opacification (PCO) can occur, where the membrane behind the lens becomes cloudy. This can be treated with a simple outpatient procedure called YAG laser capsulotomy.
C.   Bending at the waist can increase intraocular pressure and put strain on the eye, which can hinder healing or increase the risk of complications. The client should be advised to avoid bending over and instead use alternative methods, such as bending their knees or getting assistance to reach items on the ground.
D.   In modern cataract surgery, many procedures are performed without sutures or with self-sealing techniques that do not require suture removal. The specific follow-up care, including whether sutures need to be removed, should be confirmed with the surgeon.
E.   Wearing an eye shield at night helps protect the eye from accidental rubbing or injury while sleeping, which is crucial for proper healing. The client should follow the physician's instructions regarding the duration of shield use, but wearing it until cleared by the physician is generally recommended to ensure the eye remains protected during the initial healing period.

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Correct Answer is A

Explanation

A. Peaked T-waves and a widened QRS complex on an ECG are often signs of hyperkalemia, which is an elevated potassium level in the blood. This can be a serious complication of acute kidney injury (AKI), especially in the oliguric phase when the kidneys are unable to effectively excrete potassium.A
B. While fluid management is important in AKI, administering a bolus of normal saline is not the first priority in the presence of suspected hyperkalemia. The primary concern is to address the electrolyte imbalance.

C. Administering potassium chloride would worsen hyperkalemia and should be avoided.
D. Kayexalate is a medication used to treat hyperkalemia by exchanging sodium ions for potassium ions in the gastrointestinal tract. However, checking the potassium level is the first step in confirming the diagnosis and determining the appropriate treatment.

A. "It is caused by the overproduction of T3, T4, and calcitonin by the thyroid gland." B. "It is caused by the lack of production of adrenocorticotropic hormone by the pituitary gland." C. "It is caused by the lack of production of thyroid stimulating hormone by the pituitary gland." D. "It is caused by the lack of production of aldosterone by the adrenal gland."

Correct Answer is C

Explanation

A. Secondary hypothyroidism is characterized by insufficient production of thyroid hormones (T3 and T4) due to inadequate stimulation from the pituitary gland, not due to overproduction. Overproduction of thyroid hormones would typically be associated with hyperthyroidism, not hypothyroidism.
B. Adrenocorticotropic hormone (ACTH) stimulates the adrenal glands to produce cortisol. A deficiency in ACTH would lead to adrenal insufficiency or Addison's disease, not secondary hypothyroidism.
Secondary hypothyroidism specifically involves a deficiency in thyroid-stimulating hormone (TSH), not ACTH.
C. Secondary hypothyroidism is caused by inadequate production of thyroid-stimulating hormone (TSH) by the pituitary gland. TSH is necessary for stimulating the thyroid gland to produce thyroid hormones (T3 and T4). When the pituitary gland does not produce enough TSH, the thyroid gland is not adequately stimulated, leading to low levels of thyroid hormones in the blood.
D. Aldosterone is a hormone produced by the adrenal glands that helps regulate sodium and potassium levels, as well as blood pressure. A deficiency in aldosterone is associated with conditions such as
Addison’s disease or primary adrenal insufficiency, not secondary hypothyroidism. Secondary
hypothyroidism specifically relates to issues with TSH production, not aldosterone.

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A nurse is providing discharge education to a client who has undergone extracapsular cataract extraction surgery. What should the nurse include in the discharge teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is in the oliguric phase of acute kidney injury (AKI) which was caused by massive tissue trauma. The nurse notes peaked T-waves and a widened QRS complex on the cardiac monitor. What is the first action the nurse should take?

Correct Answer is A

Explanation

A staff nurse is teaching a client who has secondary hypothyroidism about the disease process. The client asks the nurse what causes secondary hypothyroidism. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

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