A nurse is providing teaching to a client with a colostomy about appropriate food choices. Which of the following foods should the nurse include in the teaching?

Choice A reason:

Blurred vision: While blurred vision can occur in some cases of meningitis, it is not one of the most common or definitive symptoms. Meningitis primarily affects the meninges, leading to symptoms like headache, fever, and neck stiffness. Blurred vision might be a secondary symptom due to increased intracranial pressure, but it is not as typical as other symptoms.

Choice B reason:

Severe headache: A severe headache is a hallmark symptom of meningitis. This headache is often described as intense and different from typical headaches. It is caused by the inflammation of the meninges, which are the protective membranes covering the brain and spinal cord. The headache is usually accompanied by other symptoms such as fever, neck stiffness, and sensitivity to light.

Choice C reason:

Oriented to person, place, and year: Being oriented to person, place, and year indicates normal cognitive function. However, meningitis can cause confusion, altered mental status, and even loss of consciousness in severe cases. Therefore, this finding would not be expected in a client with meningitis.

Choice D reason:

Bradycardia: Bradycardia, or a slow heart rate, is not typically associated with meningitis. Meningitis symptoms are more related to the central nervous system and include fever, headache, neck stiffness, and altered mental status. Bradycardia might occur in other conditions but is not a common finding in meningitis.

The correct answers are:

Condition:

• a. Pneumothorax
  (After a thoracotomy and chest tube insertion, pneumothorax is a potential complication as air can accumulate in the pleural space, compromising lung expansion.)

Actions:

• b. Administer oxygen as prescribed.
  (To ensure adequate oxygenation while resolving the pneumothorax)
• b. Ensure the chest tube is functioning properly.
  (Ensuring the chest tube is removing air from the pleural space to restore lung expansion)

Parameters to Monitor:

• c. Respiratory rate and effort.
  (To assess the client's respiratory status and detect any changes indicating distress or worsening pneumothorax)
• c. Oxygen saturation levels.
  (To continuously assess oxygenation and detect any hypoxia)

Rationale:

A pneumothorax is more likely post-thoracotomy, especially with a chest tube insertion, as air is a primary concern in the pleural space. Monitoring respiratory parameters like oxygen saturation and respiratory effort helps evaluate the client's respiratory function and chest tube efficacy.