Which of the following are contraindications for administering a tap water enerna? (Select all that apply)
Electrolyte imbalance risk
Acute appendicitis
Severe dehydration
Regular use of laxatives
History of bowel surgery
Normal bowel function
Increased fluid intake
Correct Answer : A,B,C,E
Rationale:
A. Tap water enemas are hypotonic, and repeated or large-volume use can lead to hyponatremia or other electrolyte disturbances, particularly in infants, elderly clients, or those with renal or cardiac issues.
B. Administering a tap water enema in a client with suspected appendicitis can increase intra-abdominal pressure, potentially causing perforation or worsening the condition.
C. Tap water enemas can further disrupt fluid and electrolyte balance in clients who are already dehydrated, exacerbating their condition.
D. Regular use of laxatives is not a strict contraindication for a tap water enema but may reduce its effectiveness over time due to bowel adaptation.
E. Clients with recent bowel surgery or structural abnormalities are at higher risk for perforation or injury when receiving an enema.
F. Tap water enemas are not indicated for clients with normal bowel function because they are unnecessary and can cause discomfort or dependence.
G. While maintaining hydration is important, it does not contraindicate the use of a tap water enema; it may actually support bowel function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Right upper quadrant contains the liver and gallbladder; pain here is more typical of hepatobiliary disorders, not appendicitis.
B. Right lower quadrant is the correct location of McBurney’s point, found one-third of the distance from the anterior superior iliac spine to the umbilicus. Tenderness here is a classic sign of appendicitis.
C. Left lower quadrant pain is commonly associated with conditions like diverticulitis, not appendicitis.
D. Left upper quadrant contains the stomach, spleen, and pancreas tail; pain here suggests disorders of those organs, not appendicitis.
Correct Answer is D
Explanation
Rationale:
A. Simply saline locking the IV catheter would interrupt the continuous infusion of nutrients, which can lead to hypoglycemia in clients receiving TPN.
B. Hanging only the IV fat emulsion is insufficient to meet the client’s total nutritional and caloric needs; it does not prevent hypoglycemia.
C. Calling the provider for new TPN orders is unnecessary if the original prescription is still valid; the priority is maintaining glucose levels until the TPN arrives.
D. If the TPN solution is unavailable, D₁₀W (10% dextrose in water) should be infused to prevent hypoglycemia, as TPN provides continuous glucose supply and abrupt discontinuation can cause dangerous drops in blood sugar.
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