A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy.
Which of the following instructions should the nurse include in the teaching?

Begin ball squeezing exercises.

Wear a bra with wire support.

Avoid using the affected arm for eating.

Use deodorant under the affected arm.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Beginning ball squeezing exercises is not advisable immediately after a modified radical mastectomy. The client's arm on the affected side needs time to heal, and strenuous exercises can strain the surgical site, increase pain, and potentially disrupt the healing process.

Choice B rationale:

Wearing a bra with wire support is not recommended, especially in the early postoperative period. Underwire bras can irritate the surgical site and interfere with the healing process. Patients are usually advised to wear soft, non-underwire bras or special post-surgical bras designed for comfort and support.

Choice C rationale:

Avoiding the use of the affected arm for eating is the correct instruction. Protecting the surgical site and preventing strain is essential for proper healing. Encouraging the client to use the opposite arm for activities like eating can minimize movement in the affected area, reducing the risk of complications.

Choice D rationale:

Using deodorant under the affected arm is not recommended immediately after surgery. The surgical site needs to be kept clean and dry to prevent infection and promote healing. Deodorants, especially those containing chemicals or fragrances, can irritate the skin and increase the risk of complications. Patients are usually advised to avoid applying any products to the surgical area until it is fully healed.

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Correct Answer is D

Explanation

Choice A rationale:

Human papillomavirus (HPV) vaccination is recommended for adolescents and young adults to prevent HPV-related cancers and diseases. However, in the context of older adults, especially those who are not previously vaccinated, the priority shifts to other immunizations that are more relevant to their age group.

Choice B rationale:

Rotavirus vaccination is administered to infants to protect against rotavirus infections, which can cause severe diarrhea and dehydration. It is not a priority immunization for older adults. Older adults are at higher risk for certain diseases, and their immunization focus should be on vaccines that prevent those specific conditions.

Choice C rationale:

Diphtheria, tetanus, and acellular pertussis (DTaP) vaccination is essential for children and adults, especially for those who have not received a complete series of vaccinations. However, the question specifies older adults, and DTaP is typically administered to children. While it is crucial for healthcare providers and family members to stay up-to-date with their vaccinations, other immunizations are more pertinent for older adults.

Choice D rationale:

Herpes zoster vaccination (shingles vaccine) is recommended for adults aged 50 years and older. Herpes zoster is a painful rash caused by the reactivation of the varicella-zoster virus, which also causes chickenpox. Older adults are at higher risk of developing shingles, and vaccination can reduce the likelihood of the disease and its complications. Therefore, the nurse should recommend the herpes zoster vaccine to the group of older adults as it aligns with their age and addresses a specific health risk they face.

A. Wire cutters. B. Tracheostomy tray. C. Montgomery straps. D. Padded clamp.

Correct Answer is D

Explanation

Choice A rationale:

Wire cutters are not necessary equipment for postoperative care after a thoracotomy with chest tube placement. Wire cutters are used for cutting wires and may be found in orthopedic or surgical trays, but they are not specifically required for thoracotomy care.

Choice B rationale:

A tracheostomy tray is not necessary for postoperative care following a thoracotomy with chest tube placement. Tracheostomy trays contain supplies for managing a tracheostomy, which is a procedure involving the creation of an opening in the neck to help with breathing. This procedure is not related to thoracotomy care.

Choice C rationale:

Montgomery straps are not necessary equipment for postoperative care after a thoracotomy with chest tube placement. Montgomery straps are used to secure dressings or bandages without adhesive tape. They are not typically used in thoracotomy care.

Choice D rationale:

A padded clamp is essential equipment for postoperative care after a thoracotomy with chest tube placement. The clamp is used to temporarily close or occlude the chest tube during transportation or when changing the drainage system. This prevents air from entering the pleural space, maintaining proper suction and preventing complications such as pneumothorax.

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A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy.Which of the following instructions should the nurse include in the teaching?

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A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy.
Which of the following instructions should the nurse include in the teaching?