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. Pursed-lip breathing is an effective technique for managing COPD symptoms, particularly tachypnea and dyspnea. It helps to keep the airways open by creating back pressure that prevents the collapse of bronchioles and reduces air-trapping. This technique improves ventilation and helps with the expiration of trapped air, making it a valuable intervention for COPD patients.
B. The Trendelenburg position involves lying flat on the back with the legs elevated higher than the head. This position is not suitable for managing COPD symptoms and can actually worsen breathing difficulties by increasing abdominal pressure on the diaphragm.
C. High-frequency chest wall oscillation (HFCWO) vests are used to help with airway clearance in conditions like cystic fibrosis or chronic bronchitis by loosening mucus. While beneficial for mucus management, they do not specifically address bronchiolar collapse or air-trapping associated with COPD.
D. Measuring the FEV1/FVC ratio is a diagnostic tool used to assess the severity of airflow obstruction in COPD. While this information is important for diagnosis and treatment planning, it is not an immediate intervention to manage symptoms such as tachypnea and dyspnea.

A. Client's response to nitroglycerin therapy B. Client's initial report of manifestations C. 12 Lead EKG report D. Troponin results

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

Client's Response to Nitroglycerin Therapy

• Unstable Angina:
o Typically, unstable angina responds well to nitroglycerin. The relief of discomfort after nitroglycerin administration suggests that the chest pain was likely related to unstable angina, as it indicates a reduction in coronary artery spasm or temporary ischemia.
• Myocardial Infarction:
o In an MI, nitroglycerin may help alleviate pain, but it does not address the underlying cause of myocardial injury. The pain relief in an MI is generally more variable and may not be as effective if there is significant myocardial damage.

2. Client's Initial Report of Manifestations

• Unstable Angina:
o The symptoms described (shortness of breath, dizziness, and discomfort in the jaw, neck, and left arm) are consistent with unstable angina, which is characterized by episodes of chest pain or discomfort at rest or with minimal exertion, often associated with transient ischemia.
• Myocardial Infarction:
o These symptoms can also be consistent with MI, especially if they are severe or persistent. However, MI often presents with more intense and prolonged pain, and the discomfort might not always resolve with rest.

3. 12 Lead EKG Report

• Unstable Angina:
o ST depression on an EKG is more commonly associated with unstable angina, which indicates transient ischemia rather than a sustained myocardial injury.
• Myocardial Infarction:
o ST depression indicates ischemia commonly in angina.

4. Troponin Results

• Unstable Angina:
o Troponin levels are typically normal in unstable angina. The client’s troponin I (0.01 ng/mL) and troponin T (0.03 ng/mL) are within the normal range, suggesting no significant myocardial injury. This is consistent with unstable angina.
• Myocardial Infarction:
o Elevated troponin levels are a key marker of myocardial injury. The normal troponin results in this case do not support an MI diagnosis, as elevated troponin levels would be expected in MI.

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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 with chronic obstructive pulmonary disease (COPD) is experiencing tachypnea and dyspnea. The nurse should plan to implement which of the following interventions to reduce bronchiolar collapse and air-trapping?

Correct Answer is A

Explanation

A nurse in the emergency department is admitting a client. Exhibits For each of the following findings in the client's medical record, click to specify if they are consistent with unstable angina or a myocardial infarction (MI). Each finding may support more than one disease process.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

A nurse is caring for a client who has a diagnosis of Cushing syndrome. After performing magnetic resonance imaging (MRI), the underlying cause of the condition is found to be hyperplasia of the adrenal glands. Which of the following lab results would the nurse anticipate with this condition?

A client is diagnosed with chronic stable angina caused by plaques in the coronary arteries. The client receives a prescription for sublingual nitroglycerin to use as needed when angina occurs. Which additional medication does the nurse anticipate would be prescribed for this client?

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A nurse in an eye clinic is obtaining a health history from a client who is being evaluated for suspected cataracts. The nurse understands that which of the following medications is associated with an increased risk of developing cataracts?

A nurse is caring for an 83-year-old client who asks for a warm blanket despite the room temperature being 80°F. The nurse understands that which of the following physiological changes experienced by older adults makes it more difficult for them maintain their body temperature?

Which of the following clients is at a higher risk of developing osteoarthritis?