A nurse is teaching a client about self-administering peritoneal dialysis. Which of the following statements by the client indicates a need for further teaching?

"The microwave in my kitchen can warm the solution before I use it."

"The catheter can become infected even with sterile precautions."

"The volume of the output solution should be greater than the input solution."

"The fluid from my abdomen will be clear or slightly yellow."

Answer and Explanation

The Correct Answer is A

Choice A reason:Using a microwave to warm the solution is not recommended as it can lead to uneven heating and potentially damage the solution or harm the patient.

Choice B reason: The statement about the catheter becoming infected despite sterile precautions is accurate and reflects an understanding of the risks associated with peritoneal dialysis.

Choice C reason:Expecting the volume of the output solution to be greater than the input solution is incorrect; typically, the volumes should be equal to ensure proper fluid removal.

Choice D reason: The fluid from the abdomen being clear or slightly yellow is a normal finding and does not indicate a need for further teaching.

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Correct Answer is A

Explanation

Choice A reason: Hematemesis Hematemesis, or vomiting blood, is a serious symptom that usually indicates bleeding in the upper gastrointestinal tract. This could be due to a severe peptic ulcer, among other conditions1. The blood may appear red or black, and the condition can cause a person to go into hypovolemic shock, which can lead to organ failure and death if not treated immediately. Therefore, hematemesis should be identified as the priority symptom in this case. While all these symptoms can be associated with peptic ulcer disease, hematemesis is the most serious and should be prioritized due to the risk of significant blood loss and potential for hypovolemic shock.

Choice B reason: Abdominal bloating Abdominal bloating is a symptom that can be caused by various conditions, including indigestion, overeating, and certain medical conditions. While it can be uncomfortable, it is generally not as immediately life-threatening as hematemesis.

Choice C reason: Epigastric discomfort Epigastric discomfort refers to pain or discomfort in the upper abdomen, below the ribs. It can be caused by conditions such as acid reflux, GERD, overeating, lactose intolerance, and others. While it can be a symptom of a peptic ulcer, it is not typically as urgent as hematemesis.

Choice D reason: Dyspepsia Dyspepsia, also known as indigestion, can cause symptoms such as bloating, heartburn, and feeling full too quickly8910. It can be caused by a variety of factors, including certain foods, overeating, and medical conditions like GERD. While it can be a symptom of a peptic ulcer, it is generally not as immediately life-threatening as hematemesis.

A. Provide oral care every 4 hours and as needed B. Position the head of the client's bed in the flat position C. Turn the client every 4 hours D. Provide humidity by maintaining moisture within the ventilator tubing

Correct Answer is A

Explanation

Choice A reason:Providing oral care every 4 hours and as needed is an evidence-based practice to lower the risk of ventilator-associated pneumonia by minimizing the buildup of bacteria in the mouth³.

Choice B reason:Positioning the head of the client's bed in the flat position is not recommended as it can increase the risk of aspiration; elevating the head of the bed to 30° to 45° is the standard practice.

Choice C reason:Turning the client every 4 hours is important for preventing pressure ulcers and improving lung function but is not the primary action for reducing pneumonia risk³.

Choice D reason:Providing humidity helps to maintain mucous membrane integrity but must be carefully managed to prevent bacterial growth and is not the primary action for reducing pneumonia risk³.

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A nurse is teaching a client about self-administering peritoneal dialysis. Which of the following statements by the client indicates a need for further teaching?

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