(PrepU) Health Promotion: Nursing Concepts

A nurse cares for a female client of childbearing age who will undergo bariatric surgery. When teaching the client about precautions after surgery, which teaching will the nurse include that is specific to this population?

"You should avoid pregnancy for at least 18 months after surgery." When teaching a female of childbearing age regarding precautions after bariatric surgery, the nurse should instruct the client to avoid pregnancy for at least 18 months after surgery. The ability to conceive after weight loss surgery may improve more often than worsen. Contraceptives are no less effective after surgery than before.

Through which activity does a client learn to consciously contract excretory sphincters and control voiding cues?

Biofeedback Cognitively intact clients who have stress or urge incontinence may gain bladder control through biofeedback. Kegel exercises are pelvic floor exercises that strengthen the pubococcygeus muscle. Habit training is used to try to keep the client dry by strictly adhering to a toileting schedule and may be successful with stress, urge, or functional incontinence. Habit training is a type of bladder training.

Which type of nursing diagnosis has as its goal to increase well-being and enhance specific health behaviors?

Health promotion Health promotion nursing diagnoses identify existing problems. Risk nursing diagnoses identify potential problems and use the stem risk for, as in "risk for impaired skin integrity related to inactivity." In wellness diagnoses, the diagnostic statement begins with the stem readiness for enhanced and does not include related factors or supporting data. Actual nursing diagnoses identify existing problems.

Which of the following is inconsistent as a condition related to metabolic syndrome?

Hypotension A diagnosis of metabolic syndrome includes three of the following conditions: insulin resistance, abdominal obesity, dyslipidemia, hypertension, proinflammatory state, and prothrombotic state.

A nurse is planning care for a client who will be arriving to the unit postoperatively from bariatric surgery. In an effort to decrease the risk of venous thromboembolism (VTE), which health care provider orders does the nurse anticipate?

Mechanical compression and prophylactic anticoagulation Both mechanical compression (intermittent pneumatic compression devices) and prophylactic anticoagulation with low molecular weight heparin agents are prescribed in the client who is postoperative bariatric surgery. Early ambulation is encouraged; however, it is not the only intervention.

The nurse is teaching a class on methods of relaxation to be used for stress management. Which methods should the nurse teach the participants? Select all that apply.

Meditation Biofeedback Imagery Focused breathing Methods of relaxation that can be used for stress management are: meditation, biofeedback, imagery, and focused breathing. Acupuncture is used for pain relief, minimizing nausea and vomiting, and substance use recovery adherence.

A nurse working in the Family Birthing Center is answering the nurse hotline phone. A client calls in to schedule her annual Papanicolaou test. How could the nurse best educate the client before her procedure to make sure the results are not affected?

Refrain from sexual intercourse 48 hours before testing to ensure clear results. Nurses should use teaching guidelines with clients to optimize the Papanicolaou test results. Strategies to educate would include no douche, no tampons, no jellies, no spermicides, no intercourse. The optimal time for testing is 2 weeks after the first day of your last menses.

A 27-year-old client is a regular smoker, has diabetes, and has been diagnosed with hypertension. The client says it is cumbersome and time consuming to visit the doctor regularly just for a blood pressure check. Which aspect of teaching would the nurse use with this client?

Suggest the client purchase a self-monitoring cuff Because this client finds it time consuming to visit the health care provider just for a blood pressure reading, the nurse can suggest the client use an automatic cuff at a local pharmacy or purchase a self-monitoring cuff. Discussing methods for stress reduction, advising a smoking cessation, and applying glycemic control would constitute client education in managing hypertension.

A group of women are attending a community presentation regarding the leading health concerns of women. Which interventions should the nurse recommend to have the greatest impact on the leading cause of death?

weight control and being knowledgeable about family history of cardiovascular disease Cardiovascular disease is the leading cause of death of women in the United States. Interventions that address reduction of this risk would be a priority. Elevations in death rates are in part attributed to the difficulty recognizing cardiovascular concerns in women. The second leading cause of death in women is cancer, specifically lung and cervical. Lower respiratory tract infections have increased over recent years as a cause of death in women, but they are not the number one cause. Alzheimer disease, although impacting the mortality rates of women, is not the greatest cause of death.

The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention?

"The school is quite structured and advocates corporal punishment." The nurse needs to emphasize that there are number of reasons that a parent should not choose a preschool that utilizes corporal punishment. It may negatively affect a child's self-esteem as well as ability to achieve in school. It may also lead to disruptive and violent behavior in the classroom and should be discouraged. The other statements would not warrant further discussion or intervention.

A client is undergoing thoracic surgery. What priority education should the nurse provide to assist in preventing respiratory complications?

Splint the incision site using a pillow during deep breathing and coughing exercises. Splinting the incision site will help decrease pain and support the incision. This will increase compliance with the deep breathing and coughing exercises that assist in preventing respiratory complications. Pain medication should be taken regularly, not only before deep breathing and coughing exercises. Deep breathing and coughing exercises should be done at least every 2 hours, more frequently if possible. While some clients will find the exercises relaxing, most clients find it painful to complete them.

During assessment of a client admitted for cardiomyopathy, the nurse notes the following symptoms: dyspnea on exertion, fatigue, fluid retention, and nausea. The initial appropriate nursing diagnosis is which of the following?

Decreased cardiac output A primary nursing diagnosis for cardiomyopathy is decreased cardiac output related to structural disorders caused by cardiomyopathy or to dysrhythmia from the disease process and medical treatments. Dyspnea on exertion, fatigue, and fluid retention are related to poor cardiac output. Nausea is related to poor perfusion of the gastrointestinal system. Autonomic dysreflexia is related to a spinal cord injury. Ineffective airway clearance relates to the inability to clear secretions from the airway, which is not an initial problem with cardiomyopathy. Disturbed sensory perception is related to specific senses and not to initial cardiomyopathy.

A client presents to the ED reporting anxiety and chest pain after shoveling heavy snow that morning. The client says that nitroglycerin has not been taken for months but upon experiencing this chest pain did take three nitroglycerin tablets. Although the pain has lessened, the client states, "They did not work all that well." The client shows the nurse the nitroglycerin bottle; the prescription was filled 12 months ago. The nurse anticipates which order by the physician?

Nitroglycerin SL Nitroglycerin is volatile and is inactivated by heat, moisture, air, light, and time. Nitroglycerin should be renewed every 6 months to ensure full potency. The client's tablets were expired, and the nurse should anticipate administering nitroglycerin to assess whether the chest pain subsides. The other choices may be ordered at a later time, but the priority is to relieve the client's chest pain.

The community health nurse is seeing a mother and newborn for the first home visit. Which information best indicates an understanding of visiting clients in their home?

The home visit is a way of monitoring the well-being of all family members. Home visits offer services similar to those offered at a scheduled clinic visit, but they also give the nurse an opportunity to assess the family's adaptation and dynamics and the home environment. The other statements do not indicate the best understanding of home visits.

The school nurse is preparing a presentation about safety promotion for middle school students. Which topic should the nurse plan to include?

The importance of consistent seat belt use Seat belt use is an important safety precaution to teach audiences of all ages. Improper seat belt use (or lack of seat belt use) increases the risk for injury. It is not appropriate to teach middle school children about moderation with alcohol, workplace injury, or falls.