Following a fractured left tibia, which necessitated placement of long leg cast, a client is using crutches to ambulate. During an orthopedic follow-up visit, a client reports to the nurse having difficulty managing the crutches. Which assessment should the nurse perform?

Measure capillary refill time.

Palpate for dependent edema.

Determine degree of skin elasticity.

Note hand and forearm strength.

Answer and Explanation

The Correct Answer is D

A.   Capillary refill time assessment is more relevant for circulatory status and would not directly address the client's difficulty with crutch management.
B.   Palpating for dependent edema would not provide information directly related to the client's ability to use crutches.

C.   Assessing skin elasticity is not directly related to the client's ability to manage crutches.
D.   Strength in the hands and forearms is essential for proper crutch use, as these muscles bear much of the weight while ambulating with crutches.

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Correct Answer is D

Explanation

A. While chewing food well is important to aid digestion and prevent discomfort, meal timing and portion control are the primary concerns in gastric bypass patients.

B. Sipping fluids slowly is important, but fluids should generally be taken between meals rather than with meals to prevent stretching the stomach pouch and to avoid dumping syndrome.
C. Reducing fatty and gas-forming foods can help avoid discomfort, but this is less critical than ensuring proper food breakdown through thorough chewing.
D. After gastric bypass surgery, small, frequent meals help prevent dumping syndrome, a condition in which food moves too quickly from the stomach to the small intestine, causing nausea, dizziness, and diarrhea. Portion control is essential to avoid overstretching the reduced stomach pouch and ensure adequate nutrient absorption.

A. Help the client identify thoughts that may be triggers. B. Explore past behaviors that have provided relief. C. Attempt to distract to another focus or activity. D. Speak calmly to the client stating assurance of safety.

Correct Answer is D

Explanation

A. Identifying triggers may be beneficial, but the client is currently in a state of severe anxiety, and immediate intervention to address the symptoms is needed.
B. Exploring past behaviors can be addressed later; the immediate focus should be on managing the acute symptoms of anxiety.

C. Attempting to distract the client can be helpful, but providing reassurance and addressing safety concerns take precedence.
D. Speaking calmly to the client and providing assurance of safety is an appropriate first step in managing severe anxiety. Once the client is more settled, other interventions can be explored.

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Following a fractured left tibia, which necessitated placement of long leg cast, a client is using crutches to ambulate. During an orthopedic follow-up visit, a client reports to the nurse having difficulty managing the crutches. Which assessment should the nurse perform?

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A client who underwent an uncomplicated gastric bypass surgery is having difficulty with diet management. Which dietary instruction is most important for the nurse to explain to the client?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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Following a fractured left tibia, which necessitated placement of long leg cast, a client is using crutches to ambulate. During an orthopedic follow-up visit, a client reports to the nurse having difficulty managing the crutches. Which assessment should the nurse perform?

Four hours after surgery, a client reports nausea and begins to vomit. The nurse notes that the client has a scopolamine transdermal patch applied behind the ear. Which action should the nurse take?