The nurse is caring for an older adult client who is admitted to the surgical unit following a partial gastrectomy. In addition to frequent position changes, which postoperative intervention is most beneficial for the nurse to perform in preventing respiratory complications?

Promote full diaphragmatic excursion by massaging the back.

Note areas of atelectasis on the daily chest x-rays.

Assist to a chair the day after surgery when the condition is stable.

Provide ice or oral liquids when the client passes flatus.

Answer and Explanation

The Correct Answer is A

A.   Promoting full diaphragmatic excursion by massaging the back helps to facilitate deep breathing and lung expansion, which is essential for preventing respiratory complications such as atelectasis and pneumonia after surgery.
B.   Noting areas of atelectasis on daily chest x-rays is important for assessing respiratory status, but it is a monitoring intervention rather than a preventive intervention.
C.   Assisting the client to a chair the day after surgery when the condition is stable promotes early mobility and prevents complications such as deep vein thrombosis, but it may not directly
address respiratory complications.
D.   Providing ice or oral liquids when the client passes flatus may be part of the postoperative care plan, but it does not directly address respiratory complications. It's more related to bowel function and hydration status.

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Correct Answer is A

Explanation

Even though the client has a "Do Not Resuscitate" (DNR) order, routine care such as turning the client to prevent complications (e.g., pressure ulcers) remains important. The nurse should ensure the UAP understands the need to continue positioning the client according to the care plan, as this is a preventive measure for comfort and overall care, not a resuscitative measure.

B. Assume total care of the client to monitor neurologic function: Assuming total care may not be necessary, but providing guidance on comfort care measures is appropriate.
C.

Comfort care measures are important, but preventing complications such as pressure ulcers by turning the client is also part of providing comfort and care. Ceasing turning the client prematurely could lead to additional complications, which is not in the best interest of the patient.

D. Assign a practical nurse to assist the UAP in turning the client: While additional assistance may be helpful, ensuring that comfort care measures are provided is the priority.

A. Encourage the client to participate in group activities. B. Schedule a daily conference with the social worker. C. Engage the client in non-threatening conversations. D. Encourage the client's family to visit more often.

Correct Answer is C

Explanation

A. Encouraging the client to participate in group activities may be beneficial but may not address the immediate need for increased communication and engagement.
B. Scheduling a daily conference with the social worker may provide support but may not directly address the client's withdrawal and noncommunicative behavior.
C. Engaging the client in non-threatening conversations is important to assess the client's current emotional state, understand the reasons for withdrawal, and provide support and encouragement for communication and interaction.
D. Encouraging the client's family to visit more often may be helpful for social support, but it may not address the underlying issue of the client's withdrawal and noncommunicative behavior.

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The nurse is caring for an older adult client who is admitted to the surgical unit following a partial gastrectomy. In addition to frequent position changes, which postoperative intervention is most beneficial for the nurse to perform in preventing respiratory complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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