Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity?

Correct Answer: A

Rationale: In Sharon's case, having cirrhosis of the liver leads to impaired liver function, causing decreased production of albumin and subsequent hypoalbuminemia. This results in a decreased colloid osmotic pressure in the blood vessels, leading to fluid shifting into the peritoneal cavity and causing ascites. Restricting fluids is the necessary intervention to decrease ascites in cirrhotic patients like Sharon. By limiting fluid intake, the body's overall fluid volume decreases, reducing the amount of fluid that accumulates in the peritoneal cavity. Encouraging ambulation is beneficial for overall health but does not directly address the underlying cause of ascites. Increasing sodium in the diet can actually worsen ascites by promoting fluid retention. Giving antacids, while important for managing other GI issues, does not address ascites specifically. Educationally, understanding the pathophysiology of ascites in cirrhosis is essential for nursing students to make appropriate clinical decisions. This knowledge helps in selecting the most effective interventions to manage complications and improve patient outcomes.

Correct Answer: D

Rationale: In the case of a patient like Rob, who is suspected to have Hepatitis B and presents with jaundice and weakness, the correct intervention is option D) Rest period after small, frequent meals. This choice is appropriate because patients with Hepatitis B often experience fatigue and weakness due to the strain on their liver. Providing rest periods after meals helps to conserve energy and aids in digestion, which can be compromised in liver disease. Option A) Regular exercise is incorrect in this scenario because excessive physical activity can exacerbate fatigue and put additional stress on the liver, which is already compromised in Hepatitis B. Option B) A low-protein diet is not the best choice as protein restriction is not typically recommended for Hepatitis B patients unless there are specific complications like hepatic encephalopathy. Protein is essential for tissue repair and maintaining muscle mass, important for overall recovery. Option C) Allowing the patient to select his meals may not be ideal in this case as a patient with Hepatitis B may have dietary restrictions that need to be followed to support liver function and promote healing. Providing guidance on a suitable diet is crucial in managing the condition effectively. In a medical-surgical nursing context, understanding the specific needs of patients with liver disease such as Hepatitis B is essential. Educating patients on appropriate dietary choices, rest periods, and energy conservation strategies is crucial in promoting optimal outcomes and supporting the patient's overall well-being during their hospital stay.

Correct Answer: D

Rationale: The correct answer is option D: "My family knows that if I get tired and start vomiting, I may be getting sick again." This statement indicates patient understanding because it shows awareness of the signs and symptoms of hepatitis B recurrence, emphasizing the importance of monitoring for early indications of illness. This reflects a proactive approach to managing the condition and seeking timely medical intervention if needed. Option A is incorrect because having had hepatitis B previously does not confer immunity from future infections or reinfections. Option B is incorrect as individuals with hepatitis B are typically deferred from donating blood due to the risk of transmitting the virus. Option C is also incorrect as ongoing liver damage can occur from alcohol consumption, especially in the context of hepatitis B. From an educational perspective, this question assesses the patient's understanding of hepatitis B management and self-care measures post-discharge. It highlights the importance of patient education in promoting self-awareness, early recognition of symptoms, and adherence to follow-up care to prevent disease progression and complications.

Correct Answer: A

Rationale: The correct answer is A) "You'll need to turn from side to side every 2 hours." This response is the best because it provides accurate postoperative care instructions for the patient undergoing a cholecystectomy. Turning from side to side every 2 hours helps prevent complications such as atelectasis, pneumonia, and pressure ulcers. This action also promotes circulation, aids in respiratory function, and reduces the risk of blood clots. Option B) "It's always a good idea to rest quietly after surgery," is incorrect as complete immobility can lead to complications and delays in recovery. Mobilization and turning are essential for postoperative patients to prevent complications and promote healing. Option C) "The doctor will probably order you to lie flat for 24 hours," is incorrect as prolonged immobility in the supine position can increase the risk of respiratory complications and venous thromboembolism. Option D) "Why don't you decide about activity after you return from the recovery room?" is incorrect because decisions regarding postoperative care should be based on evidence-based practices and healthcare provider recommendations rather than patient preferences, especially in terms of essential postoperative care activities like turning and mobilization. In a medical-surgical nursing context, it is crucial to educate patients on proper postoperative care to prevent complications and promote optimal recovery. Nurses play a vital role in ensuring that patients understand and adhere to these essential care instructions to enhance their outcomes and overall well-being.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Encourage her to not worry about the future. This response is not appropriate because it dismisses the patient's valid concerns and emotions regarding her illness. As a nurse, it is essential to acknowledge and validate the patient's feelings, including anxiety about the duration of her recovery. By encouraging her not to worry, we are not addressing her emotional needs and may come across as dismissive. Option B) Encouraging the patient to express her feelings about the illness is appropriate because it promotes open communication and allows the patient to share her concerns, fears, and emotions, which can be therapeutic. Option C) Discussing the effects of hepatitis B on future health problems is also appropriate as it provides the patient with important information about the potential long-term implications of her condition, enabling her to make informed decisions about her health. Option D) Providing avenues for financial counseling if she expresses the need is also appropriate as hepatitis B treatment can be costly, and addressing financial concerns can help reduce stress and promote the patient's overall well-being. In an educational context, this question highlights the importance of therapeutic communication and addressing the holistic needs of patients beyond their physical symptoms. Nurses play a crucial role in providing emotional support, education, and resources to help patients cope with their illnesses and make informed decisions about their health.