Which response is best when a patient refuses a stool softener after pituitary surgery?

"You need the stool softener because it will be hard to defecate while you remain in bed."

"Any manipulation of the pituitary gland can cause difficulty in defecation, so stool softeners are important after your surgery."

"It is important you do not strain during bowel movements because this could result in increased pressure on your surgical site."

"You can choose not to take the stool softener if you feel you do not need it."

Answer and Explanation

The Correct Answer is C

A. "You need the stool softener because it will be hard to defecate while you remain in bed.": This is not the most appropriate response. While immobility can make bowel movements more difficult, the primary concern following pituitary surgery is the avoidance of straining due to the potential for increased intracranial pressure (ICP). The emphasis should be on avoiding pressure on the surgical site rather than general difficulties from immobility.
B. "Any manipulation of the pituitary gland can cause difficulty in defecation, so stool softeners are important after your surgery.": This is misleading. While pituitary surgery may influence certain bodily functions, the most critical concern is preventing straining to avoid raising ICP. The focus should be on explaining the rationale for avoiding pressure on the surgical site.
C. "It is important you do not strain during bowel movements because this could result in increased pressure on your surgical site.": This is the correct response. Straining during bowel movements can increase ICP, which could potentially compromise healing or lead to complications after pituitary surgery. This explanation directly addresses the patient's safety and emphasizes the need for stool softeners to prevent straining.
D. "You can choose not to take the stool softener if you feel you do not need it.": This response is inappropriate because it does not emphasize the importance of preventing straining, which is a critical consideration after pituitary surgery. The nurse should provide education on the necessity of the stool softener to avoid complications rather than leaving the decision solely to the patient.

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Correct Answer is A

Explanation

A. Elevate the head of the client's bed to 45° during meals: This is the correct action. Elevating the head during meals helps promote proper swallowing and reduces the risk of aspiration by preventing food or liquid from entering the airway. A semi-upright position is essential for clients at risk of aspiration, particularly those with dementia, who may have impaired swallowing reflexes.
B. Provide the client with oral hygiene: While important for oral health and to reduce bacteria in the mouth, this action does not directly reduce the risk of aspiration during meals. Oral hygiene is beneficial for preventing infections, but it doesn't influence the act of swallowing during eating.
C. Instruct the client to tilt their head back while swallowing: This is incorrect. Tilting the head back can cause difficulty in swallowing and increase the risk of aspiration. The correct technique is to maintain a neutral or slightly forward position of the head to allow food to travel smoothly down the esophagus and prevent it from entering the airway.
D. Turn on the television for the client during meals: This is not recommended as it can distract the client from focusing on eating. Distractions like a television may reduce the client's ability to concentrate on the swallowing process, increasing the risk of aspiration and choking.

A. Exercise safe sex practices. B. Reduce smoking to half a pack/day. C. Alcohol consumption is not a risk factor. D. Refrain from using harsh toothpastes or mouthwashes.

Correct Answer is A

Explanation

A. Exercising safe sex practices, especially in regard to human papillomavirus (HPV), is important because HPV is a known risk factor for head and neck cancers, particularly oropharyngeal cancers. Safe sex practices, including the use of barriers like condoms, can reduce the risk of HPV infection.
B. Reducing smoking to half a pack/day is still a significant risk factor for head and neck cancer. The best approach is to quit smoking completely, as even small amounts of tobacco use increase the risk of cancer.
C. Alcohol consumption is a known risk factor for head and neck cancer, particularly when combined with smoking. The nurse should educate the client to limit alcohol intake or avoid it altogether.
D. Using harsh toothpastes or mouthwashes does not significantly affect the risk of head and neck cancer. However, maintaining good oral hygiene is important for overall health.

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Which response is best when a patient refuses a stool softener after pituitary surgery?

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