What intervention would be the most important for the nurse to implement for the client with a left nephrectomy?

Correct Answer: A

Rationale: The most important intervention for a client with a left nephrectomy is to assess the intravenous fluids for rate and volume. After nephrectomy, monitoring intravenous fluids is crucial to ensure proper hydration and kidney function. Changing the surgical dressing daily, monitoring medication levels, and tracking meal intake are also important aspects of care but not as critical as ensuring adequate intravenous fluid management post-surgery.

Correct Answer: B

Rationale: Conduction is the process of heat transfer that occurs between objects or substances that are in direct contact with each other. In this process, heat is transferred from a hotter surface to a cooler surface through direct contact. This type of heat transfer does not involve the movement of the substances themselves, only the transfer of thermal energy. Radiation (Choice A) is the transfer of heat through electromagnetic waves, while convection (Choice C) is the transfer of heat through the movement of fluids. Evaporation (Choice D) is a cooling process that involves the phase change of a liquid into a gas.

Correct Answer: C

Rationale: The inappropriate action in collecting a midstream clean-catch urine specimen for urine analysis is to collect only 5 to 10 ml of urine. Adequate urine volume of 30 to 60 ml is required for accurate testing. Collecting a small amount like 5 to 10 ml may lead to inaccurate results due to insufficient sample size. It is crucial to follow proper collection techniques, such as discarding the first flow of urine, performing perineal care, and collecting an adequate volume, to ensure reliable test results.

Correct Answer: B

Rationale: Clients who smoke require more vitamin C due to increased oxidative stress and depletion of vitamin C. Smoking leads to higher levels of oxidative stress in the body, which in turn increases the utilization of vitamin C to counteract the damage caused by free radicals. Choices A, C, and D do not directly impact the body's need for vitamin C as smoking does.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) St. John's Wort. St. John's Wort is known to induce liver enzymes, particularly CYP3A4 and P-glycoprotein, which can accelerate the metabolism of certain drugs, including oral contraceptives and antidepressants. This interaction can lead to decreased effectiveness of these medications, potentially resulting in treatment failure or reduced therapeutic benefits. Option A) Iron supplement is not the correct answer because iron supplements do not typically have significant interactions with antidepressants or oral contraceptives. Option B) Garlic is also not the correct answer in this context. While garlic can interact with certain medications, it is not specifically known to interact with antidepressants or oral contraceptives in the same way that St. John's Wort does. Option C) Green tea is not the correct answer either. Green tea is generally considered safe and does not typically have significant interactions with antidepressants or oral contraceptives. Educationally, it is crucial for nurses to be aware of potential drug-herb interactions to ensure the safety and effectiveness of pharmacological treatments for clients. Providing accurate information and counseling on the use of herbal supplements can help prevent adverse effects and optimize patient outcomes. Nurses should always assess for the concurrent use of herbs and medications and educate clients on the importance of discussing all supplements with healthcare providers to avoid harmful interactions.