2. When assessing patient with nutritional needs, which patients will require follow-up from the nurse? (Select all that apply.)
a. A patient with
... [Show More] infection taking tetracycline with milk
b. A patient with irritable bowel syndrome increasing fiber
c. A patient with diverticulitis following a high-fiber diet daily
d. A patient with an enteral feeding and 500 mL of gastric residual A patient with dysphagia being referred to a speech-language
e. pathologist
ANS: A, C, D
The nurse should follow up with the tetracycline, diverticulitis, and enteral feeding. Tetracycline has decreased drug absorption with milk and antacids and has decreased nutrient absorption of calcium from binding.
Nutritional treatment for diverticulitis includes a moderate- or low-residue diet until the infection subsides. Afterward, prescribing a high-fiber diet for chronic diverticula problems ensues. A patient with a gastric residual volume of 500 mL needs to have the feeding withheld and reassessed for tolerance to feedings. All the rest are normal and expected and do not require follow-up. Patients manage irritable bowel syndrome by increasing fiber, reducing fat, avoiding large meals, and avoiding lactose or sorbitol-containing foods for susceptible individuals. Initiate consultation with a speech-language pathologist for swallowing exercises and techniques to improve swallowing and reduce risk of aspiration for a patient with dysphagia.
3. To honor cultural values of patients from different ethnic/religious
groups, which actions demonstrate culturally sensitive care by the nurse? (Select all that apply.)
a. Allows fasting on Yom Kippur for a Jewish patient
b. Allows caffeine drinks for a Mormon patient
c. Serves no ham products to a Muslim patient
1
d. Serves kosher foods to a Christian patient
e. Serves no meat or fish to a Hindu patient
ANS: A, C, E
The Jewish religion fasts 24 hours on Yom Kippur and must adhere to kosher food preparation methods. Hinduism requires no meats or fish. Muslims do not eat pork. Mormons do not drink caffeinated or alcoholic drinks.
MULTIPLE CHOICE
1. The nurse is caring for a surgical patient, when the family member
asks what perioperative nursing means. How should the nurse respond?
a. Perioperative nursing occurs in preadmission testing.
b. Perioperative nursing occurs primarily in the postanesthesia care unit. Perioperative nursing includes activities before, during, and after
c. surgery.
Perioperative nursing includes activities only during the surgical procedure.
ANS: C
Perioperative nursing care occurs before, during, and after surgery.
Preadmission testing occurs before surgery and is considered preoperative. Nursing care provided during the surgical procedure is considered intraoperative, and in the postanesthesia care unit, it is considered postoperative. All of these are parts of the perioperative phase, but each individual phase does not explain the term completely.
2. The nurse is caring for a patient who is scheduled to undergo a surgical procedure. The nurse is completing an assessment and reviews the patient’s
laboratory tests and allergies and prepares the patient for surgery. In which perioperative nursing phase is the nurse working?
a. Perioperative
b. Preoperative
c. Intraoperative
d. Postoperative
ANS: B 2
Reviewing the patient’s laboratory tests and allergies is done before
surgery in the preoperative phase. Perioperative means before, during, and after surgery. Intraoperative means during the surgical procedure in the operating suite; postoperative means after the surgery and could occur in the postanesthesia care unit, in the ambulatory surgical area, or on the hospital unit.
3. The nurse is caring for a patient in the postanesthesia care unit. The patient has developed profuse bleeding from the surgical site, and the
surgeon has determined the need to return to the operative area. How will the nurse classify this procedure?
a. Major
b. Urgent
c. Elective
d. Emergency
ANS: D
1) An emergency procedure must be done immediately to save a life or preserve the function of a body part. An example would be repair of a perforated appendix, repair of a traumatic amputation, or control of internal hemorrhaging. An urgent procedure is necessary for a patient’s health and often prevents additional problems from developing. An example would be excision of a cancerous tumor, removal of a gallbladder for stones, or vascular repair for an obstructed artery. An elective procedure is performed on the basis of the patient’s choice; it is not essential and is not always necessary for health. An example would be a bunionectomy, plastic surgery, or hernia reconstruction. A major procedure involves extensive reconstruction or alteration in body parts; it poses great risks to well-being. An example would be a coronary artery bypass or colon resection. [Show Less]