A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply)

“I will consume less caffeine and spicy foods"

"I will sleep with the head of my bed elevated”

"I will lie down for one half hour after meals”

“I will drink less fluid"

"I will try not to gain weight”

Answer and Explanation

Correct Answer : A,B,E

A. "I will consume less caffeine and spicy foods":
Spicy foods and caffeine can irritate the esophagus, exacerbating symptoms of hiatal hernia. Avoiding these can help in managing symptoms.

B. "I will sleep with the head of my bed elevated”:
Keeping the head elevated can prevent stomach acid from flowing back into the esophagus, reducing symptoms like heartburn. This is a helpful strategy for managing hiatal hernia.

C. "I will lie down for one half hour after meals”:
Lying down after meals can worsen symptoms because gravity can't help keep stomach acid in the stomach. Staying upright after eating helps prevent acid reflux.

D. "I will drink less fluid":There is no need to reduce fluid intake. Staying hydrated is important, and fluids do not typically contribute to hiatal hernia symptoms. However, drinking large amounts of fluid with meals should be avoided as it can increase stomach pressure.

E. "I will try not to gain weight”:
Maintaining a healthy weight is important. Excess weight can increase pressure on the abdomen, potentially worsening hiatal hernia symptoms.

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Correct Answer is A

Explanation

A. Avoid replacing the NG tube if it is accidentally dislodged:After a gastrectomy, improper placement or reinsertion of the NG tube can disrupt the surgical site, leading to complications such as bleeding, leakage, or perforation. If the tube is accidentally dislodged, the nurse should notify the surgeon or provider, as reinsertions in postoperative gastric surgery clients are typically performed under their direction.

B. Irrigate the blue pigtail port with sterile saline:The blue pigtail port (air vent) of a double-lumen NG tube (e.g., Salem sump) should not be irrigated with saline because it functions as an air vent to prevent suction from damaging the stomach lining.

C. Verify tube placement by injecting air into the larger lumen:Injecting air to verify NG tube placement is no longer considered a reliable or evidence-based practice. Placement should be verified by other methods, such as aspiration of gastric contents, pH testing, or radiographic confirmation, especially in postoperative clients.

D. Avoid the nares when providing hygiene care:Hygiene care for the nares is essential to prevent skin breakdown and discomfort in clients with an NG tube. Neglecting the nares could lead to excoriation, pressure injuries, or infection.

A. Assume position with legs and rectum lower than the stomach. B. Drink cold liquids. C. Ambulate several times a day. D. Use a straw.

Correct Answer is C

Explanation

A. Assume position with legs and rectum lower than the stomach.

Explanation: This position helps gas move through the intestines more effectively, relieving abdominal distension and promoting the passage of flatus. It's a commonly recommended position for patients experiencing discomfort due to abdominal gas.
B. Drink cold liquids.

Explanation: Drinking cold liquids might not directly help with abdominal distension and flatus. Warm liquids, on the other hand, can sometimes promote digestion and relieve gas discomfort.
C. Ambulate several times a day.

Explanation: Ambulation or walking encourages movement in the intestines, aiding in the passage of gas. It also promotes overall bowel function and can help prevent postoperative complications like atelectasis and deep vein thrombosis.
D. Use a straw.

Explanation: Using a straw doesn't have a direct impact on relieving abdominal distension or flatus. It's more relevant for patients who might have difficulty drinking directly from a glass due to medical conditions or after certain types of surgeries

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A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is contributing to the plan of care of a client who is postoperative following a gastrectomy and has a double-lumen nasogastric (NG) tube. Which of the following interventions should the nurse include in the plan?

Correct Answer is A

Explanation

A nurse is caring for a client who is 2 days postoperative from abdominal surgery. The client reports discomfort from abdominal distension and flatus. Which of the following suggestions should the nurse include?

Correct Answer is C

Explanation

A nurse is caring for a client who is postoperative and has an NG tube that has drained 2,500 ml. In the past 6 hr. The nurse should monitor the client for which of the following electrolyte Imbalances?

A nurse is caring for a client who has cirrhosis and a prescription for lactulose. Following administration, the nurse should monitor the client for which of the following adverse effects?

A nurse is checking a client's bowel sounds. At which of the following times should the nurse auscultate the client's abdomen?

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