Which information should the nurse include when giving discharge instructions to a client following a left eye cataract extraction with a lens implant?
Observe pupil response of the right eye.
Turn, cough, and deep breathe every 2 hours.
Sleep flat in a supine position.
Administer a stool softener.
The Correct Answer is D
D A stool softener can help prevent straining during bowel movements, which could increase intraocular pressure and potentially harm the surgical site. Additionally, the nurse should advise the client to avoid activities that could increase pressure in the eye, such as bending at the waist, lifting heavy objects, or engaging in strenuous activities for a certain period post-surgery.
A Monitoring for changes in pupillary sizes is not specific to this type of surgery.
B Turn, cough, and deep breathe every 2 hours: This instruction is more relevant for clients who have undergone surgery or are at risk of developing respiratory complications, such as pneumonia. It is not specifically related to cataract extraction with a lens implant.
C Clients are usually advised to sleep with the head elevated or to avoid lying on the operative side to minimize the risk of intraocular pressure changes and discomfort.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. The client's symptoms, including persistent upper abdominal pain radiating to the back, vomiting, elevated temperature, and elevated serum amylase and lipase levels, are indicative of acute pancreatitis. Post-cholecystectomy pancreatitis can occur as a complication of cholecystectomy, particularly if there is injury to the pancreas or if a gallstone becomes lodged in the common bile duct during surgery.
A. While biliary duct obstruction is a potential complication of cholecystectomy, the client's symptoms are more consistent with acute pancreatitis.
B. The client's symptoms and laboratory findings are more indicative of acute pancreatitis rather than hepatorenal failure.
C. The client's symptoms are not consistent with a typical surgical site infection.
Correct Answer is B
Explanation
B. Postural drainage involves placing the client in various positions to help drain secretions from different lobes of the lungs. There are typically five standard positions: head-down, head-up, on the side with the affected lung uppermost, on the side with the affected lung lowermost, and lying prone.
A. Performing postural drainage immediately after meals is not recommended because it can increase the risk of vomiting or aspiration, especially in individuals with chronic obstructive pulmonary disease (COPD) who may already have compromised lung function.
C. In postural drainage, the client is typically instructed to breathe deeply and slowly to maximize the effectiveness of the technique.
D. While ABGs may be necessary for monitoring respiratory status in clients with COPD, they are not specifically required prior to performing postural drainage.
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