A nurse is reinforcing teaching with a client who reports right shoulder pain following a laparoscopic cholecystectomy. Which of the following statements should the nurse make?
"The pain occurs as a residual pain from cholecystitis."
"The pain results from lying in one position too long during surgery."
"The pain is caused from the nitrous dioxide injected into the abdomen."
"The pain will dissipate if you ambulate frequently."
The Correct Answer is D
A. Postoperative pain typically resolves after a laparoscopic cholecystectomy since the surgery removes the gallbladder
B. While positioning during surgery can cause discomfort, isolated right shoulder pain is more commonly attributed to the diaphragmatic irritation from residual nitrous oxide in the abdomen.
C. Nitrous dioxide used during laparoscopic procedures is not associated with referred pain to the right shoulder. The pain is due to carbon dioxide gas used during the procedure resulting in the irritation of the diaphragm.
D. This pain is often due to the carbon dioxide used to inflate the abdomen during surgery, which can irritate the diaphragm and refer pain to the shoulder. Ambulation helps to absorb the gas more quickly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. This is partially correct but lacks the detail that the examination is done via an endoscope through the throat.
B. An endoscopic retrograde cholangiopancreatography (ERCP) involves the use of an endoscope to visualize and treat problems in the bile ducts, gallbladder, and pancreas.
C. This statement reflects a misunderstanding of the procedure, as ERCP does not involve shock waves to treat gallstones.
D. This statement also reflects a misunderstanding, as ERCP is primarily a diagnostic procedure and does not involve direct medication delivery to the gallbladder.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Bleeding: The client's platelet count has dropped from 160,000/mm³ to 100,000/mm³, which is below the normal range (150,000 to 400,000/mm³). Platelets are essential for blood clotting, and a low count increases the risk of bleeding. Additionally, the prolonged PT (13.5 seconds) and elevated INR (2.2) further indicate a tendency toward bleeding.
Infection: The client's WBC count remains elevated at 15,500/mm³, which can be indicative of ongoing infection or inflammation. Patients with acute leukemia often have dysfunctional white blood cells, which impairs their ability to fight infections effectively.
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