A nurse is providing instructions about bowel cleansing with polyethylene glycol-electrolyte solution (PEG) for a client who is going to have a colonoscopy. Which of the following information should the nurse include?

"Drink 400 ml every hour until bowel movements are clear"

"Expect bowel movements to begin 3 hr following completion of solution. "

"To prevent dehydration, drink an additional liter of fluid during preparation time. "

"Abdominal bloating might occur"

Answer and Explanation

The Correct Answer is D

Answer: D

Rationale:

A. "Drink 400 ml every hour until bowel movements are clear": The standard recommendation for PEG is to drink a specific volume, usually 240 ml every 10 to 15 minutes, rather than 400 ml every hour. The goal is to ensure the bowel is adequately cleansed, and this rate is typically more effective in achieving that.

B. "Expect bowel movements to begin 3 hr following completion of solution": Bowel movements often start within an hour or two after starting the PEG solution rather than waiting for 3 hours after finishing it. The timing can vary, but the onset is generally sooner.

C. "To prevent dehydration, drink an additional liter of fluid during preparation time": While it is important to stay hydrated, the specific recommendation for additional fluid intake beyond the PEG solution can vary. Typically, the instructions focus on the volume of PEG solution to drink rather than specifying a set amount of additional fluid.

D. "Abdominal bloating might occur": Abdominal bloating is a common side effect of bowel cleansing preparations like PEG. It can occur due to the large volume of fluid ingested and the rapid movement of the bowel contents, making it a relevant point to include in the instructions.

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Correct Answer is C

Explanation

A. A room with another nonsurgical client: Placing a client with active tuberculosis in a room with another nonsurgical client is not appropriate because it increases the risk of transmission to other patients. Tuberculosis is highly contagious, and isolation precautions are necessary to prevent the spread of the disease.
B. A room in the ICU: While isolation precautions are necessary for a client with active tuberculosis, placing the client in the intensive care unit (ICU) may not be necessary unless the client requires critical care. However, the priority is to provide a room that meets the requirements for airborne infection isolation, which may not necessarily be in the ICU.
C. A room with air exhaust directly to the outdoor environment: This is the correct choice. A room with air exhaust directly to the outdoor environment is essential for a client with active tuberculosis. Airborne infection isolation rooms (AIIRs) have negative air pressure and special ventilation systems that prevent the circulation of air from the room to other areas of the healthcare facility, reducing the risk of transmission to healthcare workers and other patients.
D. A room that is within view of the nursing station: While it may be convenient for the nursing staff to have the client's room within view of the nursing station for monitoring purposes, the priority for a client with active tuberculosis is to ensure that they are placed in a room with appropriate airborne infection isolation precautions, including proper ventilation, to minimize the risk of transmission to others.

A. Secure the restrains to the lowest bar of the side rail. B. Ensure four fingers under the restraints to prevent constriction C. Secure the restraints using a quick release tie D. Anticipate removing the restraints every 4 hr

Correct Answer is C

Explanation

A. Secure the restraints to the lowest bar of the side rail:
This is incorrect. Restraints should not be secured to the side rails of the bed because the client may injure themselves by attempting to climb over the side rail or if the bed adjusts, it can cause excessive pressure on the restrained limb.
B. Ensure four fingers under the restraints to prevent constriction:
This is incorrect. The nurse should be able to slide two fingers under the restraint to ensure it is not too tight, rather than four fingers. Restraining too loosely may allow the client to slip out, while restraining too tightly can cause tissue damage or compromise circulation.
C. Secure the restraints using a quick-release tie:
This is the correct action. Restraints should always have quick-release ties to allow for quick removal in case of an emergency or if the client needs to be repositioned or assisted. Velcro or buckle restraints with quick-release mechanisms are commonly used to ensure easy removal.
D. Anticipate removing the restraints every 4 hr:
While it's essential to regularly assess the need for continued restraint use and ensure restraints are not overly restrictive, there's no set time interval for removing restraints. Restraints should be removed as soon as they are no longer necessary to ensure the client's safety and comfort.

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A nurse is providing instructions about bowel cleansing with polyethylene glycol-electrolyte solution (PEG) for a client who is going to have a colonoscopy. Which of the following information should the nurse include?

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