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 B

Explanation

A. The client who has a chest tube to water seal: A chest tube to water seal is primarily used to drain air or fluid from the pleural space. While the client with a chest tube may experience electrolyte imbalances due to fluid loss, hypokalemia is not directly associated with this type of drainage system.
B. The client who has a nasogastric (NG) tube to suction: Clients with nasogastric tubes to suction may experience hypokalemia due to the loss of gastric contents, which contain potassium. Suctioning removes gastric secretions, including potassium, from the body, leading to the risk of electrolyte imbalances such as hypokalemia.
C. The client who has an indwelling urinary catheter to gravity drainage: Gravity drainage of urine via an indwelling urinary catheter does not typically lead to significant potassium loss. While urinary catheterization may carry a risk of electrolyte imbalances over time, it is not as directly associated with hypokalemia as suctioning gastric contents.
D. The client who has a tracheostomy tube attached to humidified oxygen: Humidified oxygen delivery through a tracheostomy tube does not directly affect potassium levels. While clients receiving oxygen therapy may have other respiratory-related issues, hypokalemia is not typically a concern related to this type of therapy.

A. Black-colored stools B. Staining of teeth C. Red colored urine D. Constipation

Correct Answer is C

Explanation

A. Black-colored stools: Black-colored stools are not an expected side effect of IV rifampin. Black stools can result from gastrointestinal bleeding or the consumption of certain foods or medications, but they are not directly related to rifampin administration.
B. Staining of teeth: Staining of teeth, often described as orange or red discoloration, is a well-known side effect of rifampin when taken orally. However, this side effect is typically associated with long-term oral use rather than IV administration. IV rifampin is not expected to cause staining of teeth.
C. Red-colored urine: Rifampin can cause red-orange discoloration of bodily fluids, including urine, sweat, saliva, and tears. This phenomenon is harmless and reversible but can be alarming to patients. It is important to educate clients about this potential side effect to alleviate concerns.
D. Constipation: Constipation is not a common side effect of rifampin. While gastrointestinal disturbances such as nausea, vomiting, and diarrhea can occur with rifampin therapy, constipation is not typically reported. If a client experiences persistent constipation while taking rifampin, other factors should be considered and evaluated.

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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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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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