The nurse is caring for a client who has developed dumping syndrome while recovering from a bariatric surgery. What recommendation should the nurse make to the client?

Choice A reason: Securing the drain to the client's bed sheet is not the best action for the nurse to take. This could cause the drain to be pulled or dislodged if the client moves or changes position. The nurse should secure the drain to the client's gown or abdominal binder, using a safety pin or a clip.

Choice B reason: Removing the JP drain when the drainage has ceased, covering the opening with sterile gauze, is not the correct action for the nurse to take. The nurse should not remove the drain without a physician's order, as this could cause complications such as infection, bleeding, or bile leakage. The nurse should monitor the amount and color of the drainage, and report any changes to the physician.

Choice C reason: Expelling the air from the JP bulb after emptying to re-establish suction is the correct action for the nurse to take. The JP drain works by creating a negative pressure that draws fluid from the surgical site. The nurse should empty the bulb when it is half full, and squeeze it until it collapses before closing the plug. This ensures that the suction is maintained and prevents the fluid from flowing back into the drain.

Choice D reason: Measuring the drainage every hour for the first 8 hr postoperative is not the correct action for the nurse to take. This is too frequent and unnecessary, as the drainage is expected to decrease over time. The nurse should measure the drainage every 8 to 12 hr, or as ordered by the physician, and record the volume and color. The nurse should also report any signs of infection, such as fever, pain, or foul odor.

Choice A reason: Mental alertness is not affected by the administration of hypertonic solutions. Hypertonic solutions are fluids that have a higher concentration of solutes than the blood. They draw water out of the cells and into the blood vessels, increasing the blood volume and osmolarity.

Choice B reason: Decreased pulse is not a result of administering hypertonic solutions too quickly. On the contrary, hypertonic solutions can increase the pulse rate as they increase the blood volume and pressure.

Choice C reason: Decreased blood pressure is not a consequence of administering hypertonic solutions too quickly. Hypertonic solutions can raise the blood pressure as they increase the blood volume and osmolarity.

Choice D reason: Fluid overload is the correct answer. Administering hypertonic solutions too quickly can cause fluid overload, which is a condition where the body has too much fluid in the blood vessels. This can lead to symptoms such as edema, dyspnea, crackles, and weight gain. Fluid overload can also cause heart failure, pulmonary edema, and cerebral edema.