A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching?

Resume sexual intercourse in 2 to 3 weeks.

Increased vaginal drainage typically occurs 5 days following surgery.

Artificial lubrication can be used to treat vaginal itching and dryness.

A Papanicolaou (Pap) test should be performed every 6 months.

Answer and Explanation

The Correct Answer is C

Choice A reason:
Resuming sexual intercourse in 2 to 3 weeks may not be appropriate for all patients after such a major surgery. The recovery time can vary based on individual factors, including the extent of the surgery and the patient's overall health. It's essential for patients to follow their healthcare provider's specific recommendations, which typically involve waiting until after the postoperative check-up, usually around 6 weeks, to ensure proper healing.

Choice B reason:
Increased vaginal drainage typically occurring 5 days following surgery could be a sign of infection or other complications. Normal postoperative discharge should gradually decrease over time. If a patient experiences increased drainage, especially if it's foul-smelling or accompanied by fever, they should contact their healthcare provider immediately.

Choice C reason:
After a total abdominal hysterectomy and bilateral salpingo-oophorectomy, patients may experience vaginal dryness due to decreased estrogen levels. Using artificial lubricants can help alleviate symptoms of itching and dryness, making this an appropriate instruction for postoperative care.

Choice D reason:
A Papanicolaou (Pap) test is not typically required every 6 months after a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer unless the surgery was performed as treatment for cervical cancer or serious pre-cancer. For those who had the procedure due to benign conditions, further Pap tests are generally not necessary.

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Correct Answer is C

Explanation

Choice A reason:
Keeping artificial nails trimmed is a recommended practice in healthcare settings to maintain effective hand hygiene. Long nails can harbor bacteria and make it difficult to clean hands thoroughly. However, the CDC does not provide specific guidelines on the length of artificial nails for healthcare workers.

Choice B reason:
When caring for a client with Clostridium difficile, it is recommended to wash hands with soap and water rather than using alcohol-based hand rubs. Alcohol-based hand rubs are not effective against C. difficile spores. Therefore, thorough handwashing with soap and water is necessary to remove spores.

Choice C reason:
Chlorhexidine is an antiseptic agent that provides broad-spectrum antimicrobial activity and is recommended for hand hygiene in certain situations, such as before invasive procedures or for clients who are immunosuppressed. It is effective against a wide range of bacteria, viruses, and fungi, making it a suitable choice for immunocompromised patients to reduce the risk of infection.

Choice D reason:
The use of alcohol-based hand rubs before administering eye drops is not specifically recommended. While hand hygiene is essential before any contact with a patient, there is no particular preference for alcohol-based hand rubs in this context. The primary concern is to ensure that hands are clean to prevent contamination of the eye drops or the patient's eyes.

A. "Disinfect equipment contaminated with blood or body fluids for twenty-four hours." B. "Burn soiled dressings." C. "Prevent the spread of infection with good household cleaning practices." D. "Food preparation is not your responsibility."

Correct Answer is C

Explanation

Choice A reason:
Disinfecting equipment contaminated with blood or body fluids is crucial to prevent the spread of infection, but the specific time frame of twenty-four hours is not standard practice. The Centers for Disease Control and Prevention (CDC) recommends cleaning and then disinfecting surfaces or objects that may be contaminated, using a disinfectant registered by the Environmental Protection Agency (EPA) and following the manufacturer's instructions for use.

Choice B reason:
Burning soiled dressings is not a recommended practice due to environmental concerns and potential health risks associated with burning medical waste. Instead, soiled dressings should be disposed of properly in accordance with local regulations for biohazardous waste.

Choice C reason:
Good household cleaning practices are essential for preventing the spread of infection, especially for individuals with compromised immune systems, such as those with AIDS. Regular cleaning and disinfecting of frequently touched surfaces can help reduce the risk of infection.

Choice D reason:
The statement "Food preparation is not your responsibility" is not an appropriate discharge instruction. Patients with AIDS should be informed about safe food handling practices to prevent foodborne illnesses, which they are at higher risk for due to their weakened immune systems.

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A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching?

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