A nurse is reinforcing teaching with a client who is 24 hours postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?

Apply moist heat to the incision while in bed.

Sit in a straight-backed chair.

Perform range of motion exercises by adducting the hip.

Answer and Explanation

The Correct Answer is B

Sit in a straight-backed chair. After a total hip arthroplasty, the client should avoid sitting in chairs that are too low or too soft, as they can be difficult to rise from and can risk dislocating the new hip. The client should apply ice to the incision site, not moist heat, in the first few days postoperatively. The client should avoid adducting the hip as this can also risk dislocation of the new hip joint. Hydrogen peroxide should not be used to clean the surgical incision, as it can delay wound healing.

Choice A: The client should apply ice to the incision site, not moist heat, in the first few days postoperatively.

Choice C: The client should avoid adducting the hip as this can risk dislocation of the new hip joint.

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Correct Answer is A

Explanation

Fluid overload is a potential complication of blood transfusion, and dyspnea is one of the hallmarks of fluid overload. Other signs and symptoms of fluid overload include a headache, hypertension, jugular vein distention, rapid breathing, and tachycardia.

An explanation for incorrect choices:

B. Fever is generally not associated with fluid overload but can be a sign of an adverse reaction to the blood transfusion, such as a febrile non-hemolytic transfusion reaction.

C. Pruritus is typically not associated with fluid overload but can be a sign of an adverse reaction to the blood transfusion, such as an allergic reaction.

D. Bradycardia is not typically associatedwith fluid overload but can be a sign of an adverse reaction to the blood transfusion, such as a hemolytic transfusion reaction.

A. Temperature change from 36.6° C (97.8° F) to 38.8° C (101.9° F). B. Respiratory rate change from 12/min to 20/min. C. Blood pressure change from 118/78 mm Hg to 86/50 mm Hg. D. Heart rate change from 110/min to 68/min.

Correct Answer is C

Explanation

The correct answer is choice C: Blood pressure change from 118/78 mm Hg to 86/50 mm Hg.

Choice C rationale: A significant drop in blood pressure can indicate various serious conditions, such as shock, hemorrhage, or a severe infection. The nurse should assess the client further and intervene as necessary to prevent complications.

Choice A rationale: The change in temperature may indicate the onset of a fever and requires further assessment, but it is not as immediately concerning as the sudden drop in blood pressure.

Choice B rationale: The change in respiratory rate could be a result of factors like pain, anxiety, or exercise. While it warrants further assessment, it is not as critical as the blood pressure change.

Choice D rationale: The heart rate change may be a response to medications, rest, or other factors. It should be monitored and assessed, but the priority finding is the blood pressure change, which may indicate a more severe underlying issue.

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A nurse is reinforcing teaching with a client who is 24 hours postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is monitoring a client who is undergoing a blood transfusion of packed RBCs. The nurse should recognize that which of the following findings indicates fluid overload?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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