A nurse is receiving postoperative report for a school-age child following surgery for a ruptured appendix. Which of the following prescriptions should the nurse expect?
Place the client in a supine position for the first 12 hr postoperative.
Pack the open wound with a dry gauze dressing.
Administer naproxen orally for pain 30 min prior to ambulation.
Maintain an NG tube on low intermittent suction until bowel sounds return.
The Correct Answer is D
A) Place the client in a supine position for the first 12 hr postoperative: Following surgery for a ruptured appendix, placing the child in a supine position for the first 12 hours can be inappropriate. It may be more beneficial to position the child in a semi-Fowler's position to promote drainage of any remaining infection and reduce the risk of respiratory complications.
B) Pack the open wound with a dry gauze dressing: For a postoperative wound following a ruptured appendix, using a dry gauze dressing might not be the best practice. A moist dressing can promote better healing and reduce the risk of infection. Wet-to-dry or other appropriate dressings are typically recommended based on the surgeon's instructions.
C) Administer naproxen orally for pain 30 min prior to ambulation: While managing pain is important, naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that is typically not the first choice for postoperative pain management in children. Additionally, oral medication might not be recommended immediately post-surgery, especially if the child has an NG tube or other contraindications for oral intake.
D) Maintain an NG tube on low intermittent suction until bowel sounds return: This is a standard postoperative practice for children who have had surgery for a ruptured appendix. The NG tube helps to decompress the stomach, preventing vomiting and aspiration, and helps manage bowel function until normal activity resumes, which is crucial for postoperative recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Use petroleum jelly on a cotton ball to plug your ear when shampooing.
This method can help protect the ear from water exposure during showering or shampooing. However, it doesn't address trauma or hearing impairment prevention as effectively as avoiding pressure changes.
B) Clean dried blood in your ear canal with a cotton-tipped applicator.
Using cotton-tipped applicators can cause trauma to the ear canal and potentially disrupt the surgical site, increasing the risk of complications and impairing hearing.
C) Avoid blowing your nose for 1 month after surgery.
Avoiding nose blowing is crucial because it can create pressure changes in the ear that may disrupt the healing process and cause trauma to the surgical site, leading to potential hearing impairment.
D) Notify your provider if you have popping or crackling sensations in the affected ear.
Popping or crackling sensations can be normal as the ear heals and adjusts post-surgery. While it’s important to monitor symptoms, reporting them is not necessarily about preventing trauma or hearing impairment.
Correct Answer is A
Explanation
A. Check skin temperature distal to the injury with the dorsum of the hand.: Assessing skin temperature distal to the injury is an important part of evaluating neurovascular status. It helps to identify any changes in circulation or potential complications like ischemia. The dorsum of the hand is commonly used as it provides a good comparison to the temperature of the affected extremity.
B. Press the heel of the foot to determine capillary refill.: While capillary refill is an important assessment, it is usually measured by pressing the nail beds or pads of the fingers and toes, not by pressing the heel. This method does not provide a reliable indication of neurovascular status.
C. Monitor sensation by palpating the pad of the great toe with a blunt needle.: While assessing sensation is important, it is typically done using a light touch or pinprick, rather than palpating with a blunt needle. The use of a needle is not standard practice for this type of assessment.
D. Compare the color of the skin proximal to the injury with the other extremity.: Comparing the skin color distal to the injury with the unaffected extremity is more relevant for evaluating neurovascular status. Proximal comparison is less effective in assessing circulation and potential issues related to the injury.
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