The nurse is providing discharge teaching to a client after a total hip replacement. The teaching should include instructions to:

Avoid crossing the legs while sitting.

Eliminate Vitamin K from the diet.

Follow a home exercise program.

Use a raised toilet seat.

Increase high-impact activities.

Answer and Explanation

Correct Answer : A,C,D

Choice a reason:
Avoiding crossing the legs while sitting is crucial after a total hip replacement to prevent dislocation of the new joint. Crossing the legs can put undue pressure on the hip joint and may lead to misalignment or increased strain during the healing process.

Choice b reason:
Eliminating Vitamin K from the diet is not typically recommended after a total hip replacement. Vitamin K is essential for blood clotting, and maintaining a consistent intake is important, especially if the client is on anticoagulant therapy to prevent deep vein thrombosis. Sudden changes in Vitamin K intake can affect the efficacy of anticoagulants like warfarin.

Choice c reason:
Following a home exercise program is an essential part of recovery after a total hip replacement. Exercises help strengthen the muscles around the new joint, improve flexibility, and increase range of motion. It's important that these exercises are done regularly and as instructed by a physical therapist.

Choice d reason:
Using a raised toilet seat after hip replacement surgery helps to prevent excessive flexion at the hip, which can risk dislocating the new joint. It also makes it easier for the client to sit down and stand up with less strain on the hip.

Choice e reason:
Increasing high-impact activities is not recommended after a total hip replacement, especially in the early stages of recovery. High-impact activities can put excessive stress on the new joint and may lead to complications. Low-impact activities such as walking, swimming, or cycling are generally more appropriate.

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Correct Answer is A

Explanation

Choice A Reason:
Sodium levels in the blood should normally be between 135 and 145 mEq/L. A level of 152 mEq/L is considered high and can be indicative of hypernatremia, which requires prompt medical attention to address potential dehydration, kidney issues, or other underlying conditions.

Choice B Reason:
Potassium levels should be within the range of 3.5 to 5.2 mEq/L for adults. A result of 3.8 mEq/L falls within the normal range, indicating no immediate concern regarding potassium levels.

Choice C Reason:
Calcium levels in the blood are typically between 8.6 and 10.2 mg/dL for adults. Therefore, a calcium level of 10.0 mg/dL is within the normal range and does not require urgent reporting to a physician.

Choice D Reason:
Creatinine levels in the blood should be between 0.6 to 1.3 mg/dL in adults, depending on factors such as age, gender, and muscle mass. A level of 1.2 mg/dL is at the higher end of the normal range but is not typically considered critical unless there are other signs of kidney dysfunction.

A. Give the ordered dose of dantrolene. B. Call the physician for an order for metoprolol. C. Increase the rate of lactated Ringer's. D. Ask the physician to order liver function tests.

Correct Answer is A

Explanation

Choice A Reason:
Dantrolene is used in the management of malignant hyperthermia, a life-threatening complication characterized by muscle rigidity and elevated temperature, often triggered by certain anesthetics. The patient's symptoms of muscle rigidity and brown urine, which may indicate myoglobinuria, along with elevated temperature and heart rate, are suggestive of this condition. Dantrolene acts by reducing calcium release from the sarcoplasmic reticulum of skeletal muscle, thereby reducing muscle contraction and metabolic demand.

Choice B Reason:
Metoprolol, a beta-blocker, is not the first-line treatment for symptoms suggestive of malignant hyperthermia. While it can reduce heart rate and blood pressure, it does not address the underlying pathophysiology of malignant hyperthermia and is not indicated in this scenario.

Choice C Reason:
Increasing the rate of lactated Ringer's solution is not the primary intervention for malignant hyperthermia. While maintaining hydration is important, it does not directly counteract the pathophysiological processes at play in malignant hyperthermia.

Choice D Reason:
While liver function tests can be important in assessing overall organ function post-operatively, they are not the immediate priority in a suspected case of malignant hyperthermia. The priority is to treat the acute and life-threatening symptoms first.

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The nurse is providing discharge teaching to a client after a total hip replacement. The teaching should include instructions to:

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing pre-operative laboratory studies of an adult client on a medical-surgical unit. Which result should be reported to the physician immediately?

Correct Answer is A

Explanation

The nurse is assessing a post-operative client and notices that the client's urine is brown and they are experiencing muscle rigidity. The vital signs are T: 102.5 F; HR: 112; RR: 20 and BP 124/84. What is the most appropriate nursing action?

Correct Answer is A

Explanation

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