Hesi RN Adult Health
Hesi RN Adult Health ( 57 Questions)
He has a past medical history of hypertension, heart failure, type 1 diabetes mellitus, cholelithiasis, and cholangitis. Which physician orders would the nurse anticipate being prescribed after reporting findings? Select all that apply.
No explanation
Gravity Facilitates Drainage: Positioning the patient strategically utilizes gravity to encourage the flow of fluids and secretions away from the surgical site. This aids in preventing fluid accumulation and potential infection. Reduces Pressure on Surgical Site: Certain positions can minimize pressure on the incision and internal organs, promoting healing and reducing discomfort. This is particularly important for patients with comorbidities like hypertension and heart failure, as they may have impaired wound healing and be more susceptible to respiratory complications. Enhances Respiratory Function: Specific positions can improve lung expansion and ventilation, which is essential for patients with a history of heart failure or respiratory issues. This helps prevent atelectasis (collapsed lung areas) and pneumonia, which are common postoperative risks. Common Post-Cholecystectomy Positions: Semi-Fowler's Position: The head of the bed is elevated 30-45 degrees, with knees slightly bent. This position eases breathing, reduces pressure on the incision, and promotes drainage of fluids. Right Side-Lying Position: The patient lies on their right side with a pillow between their knees. This position encourages drainage from the liver and gallbladder, aiding in bile flow. Left Side-Lying Position: The patient lies on their left side with a pillow between their knees. This position promotes drainage from the stomach and pancreas, assisting in digestion. Supine Position: The patient lies flat on their back with a pillow under their knees. This position may be used for short periods, but prolonged supine positioning can increase pressure on the incision and lungs. High Fowler's Position: The head of the bed is elevated 60-90 degrees, with knees slightly bent. This position is often used for patients with respiratory issues or difficulty breathing, as it improves lung expansion.
Performing drainage immediately after meals aids in efficient removal of bile and gastric secretions, preventing complications such as: Bile Reflux: Delayed drainage can cause bile to back up into the stomach, leading to nausea, vomiting, and discomfort. Infection: Accumulation of fluids in the surgical site can increase the risk of bacterial growth and infection. Pancreatitis: In rare cases, delayed drainage can cause inflammation of the pancreas due to obstruction of the pancreatic duct. I'll address the rationales for choices A and D in the following sections.
No explanation
Choice B rationale:
Gravity Facilitates Drainage:
Positioning the patient strategically utilizes gravity to encourage the flow of fluids and secretions away from the surgical site. This aids in preventing fluid accumulation and potential infection.
Reduces Pressure on Surgical Site:
Certain positions can minimize pressure on the incision and internal organs, promoting healing and reducing discomfort.
This is particularly important for patients with comorbidities like hypertension and heart failure, as they may have impaired wound healing and be more susceptible to respiratory complications.
Enhances Respiratory Function:
Specific positions can improve lung expansion and ventilation, which is essential for patients with a history of heart failure or respiratory issues.
This helps prevent atelectasis (collapsed lung areas) and pneumonia, which are common postoperative risks.
Common Post-Cholecystectomy Positions:
Semi-Fowler's Position:
The head of the bed is elevated 30-45 degrees, with knees slightly bent.
This position eases breathing, reduces pressure on the incision, and promotes drainage of fluids. Right Side-Lying Position:
The patient lies on their right side with a pillow between their knees.
This position encourages drainage from the liver and gallbladder, aiding in bile flow. Left Side-Lying Position:
The patient lies on their left side with a pillow between their knees.
This position promotes drainage from the stomach and pancreas, assisting in digestion. Supine Position:
The patient lies flat on their back with a pillow under their knees.
This position may be used for short periods, but prolonged supine positioning can increase pressure on the incision and lungs. High Fowler's Position:
The head of the bed is elevated 60-90 degrees, with knees slightly bent.
This position is often used for patients with respiratory issues or difficulty breathing, as it improves lung expansion.
Choice C rationale:
Performing drainage immediately after meals aids in efficient removal of bile and gastric secretions, preventing complications such as:
Bile Reflux:
Delayed drainage can cause bile to back up into the stomach, leading to nausea, vomiting, and discomfort. Infection:
Accumulation of fluids in the surgical site can increase the risk of bacterial growth and infection. Pancreatitis:
In rare cases, delayed drainage can cause inflammation of the pancreas due to obstruction of the pancreatic duct.
I'll address the rationales for choices A and D in the following sections.