Week 2: Health Literacy & Patient Education EAQ

A client with jaundice associated with hepatitis expresses concern over the change in skin color. What does the nurse explain is the cause of this color change? Stimulation of the liver to produce an excess quantity of bile pigments Inability of the liver to remove normal amounts of bilirubin from the blood Increased destruction of red blood cells during the acute phase of the disease Decreased prothrombin levels, leading to multiple sites of intradermal bleeding

Inability of the liver to remove normal amounts of bilirubin from the blood Rationale: Damage to liver cells affects the ability to facilitate removal of bilirubin from the blood, with resulting deposition in the skin and sclera. With hepatitis, the liver does not secrete excess bile. Destruction of red blood cells does not increase in hepatitis. Decreased prothrombin levels cause spontaneous bleeding, not jaundice.

The nurse is caring for a client who is receiving azathioprine, cyclosporine, and prednisone before receiving a kidney transplant. What does the nurse identify as the purpose of these drugs? Stimulate leukocytosis Provide passive immunity Prevent iatrogenic infection Reduce antibody production

Reduce antibody production

A client who is receiving radiation therapy for bone cancer lives alone and works full time. What should the nurse encourage this client to do? 1Perform regularly scheduled aerobic activity daily. 2Take a leave of absence from work when receiving therapy. 3Include rest periods during the day while receiving radiation. 4Continue the activities usually performed before becoming ill.

3Include rest periods during the day while receiving radiation.

Non-weight bearing with crutches has been prescribed for a client with a leg injury. The nurse provides teaching before ambulation is begun. To facilitate walking with crutches, what is the most important activity the nurse should teach the client? Sit up in a chair to help strengthen back muscles. Keep the unaffected leg in extension and abduction. Exercise the triceps, finger flexors, and elbow extensors. Use a trapeze frequently to strengthen the biceps muscles.

Exercise the triceps, finger flexors, and elbow extensors.

A nurse provides discharge teaching to a client who had a total hip replacement. The client states that the plan is to go swimming at the community pool the day after discharge. How should the nurse respond? Instruct the client to take a friend along for safety. Encourage participation in this activity, because it provides excellent range-of-motion exercise. Explain that the incision should not be immersed in water until it has healed. Let the client know that swimming can substitute for the prescribed physical therapy.

Explain that the incision should not be immersed in water until it has healed.

A client who is taking rifampin tells the nurse, "My urine looks orange." What action will the nurse take? Explain this is expected. Check the liver enzymes. Strain the urine for stones. Ask what foods were eaten.

Explain this is expected.

A nurse is teaching parents of toddlers about why children receiving specific medications should not receive varicella vaccines. Which medication will be included in the discussion? 1. Insulin 2. Steroids 3. Antibiotics 4. Anticonvulsants

2. Steroids Rationale: Steroids have an immunosuppressive effect. It is thought that resistance to certain viral diseases, including varicella, is greatly decreased when a child takes steroids regularly

A client is scheduled for radiation treatments Monday through Friday. The client asks why the treatments will not be given on Saturday and Sunday. Which is the nurse's best response? "This type of schedule gives noncancerous cells time to recover." "The department only operates from Monday through Friday." "Your energy level will be increased greatly by a 5-day schedule." "Side effects are eliminated when treatment is administered for 5 rather than 7 days."

"This type of schedule gives noncancerous cells time to recover."

A nurse teaches a client about side effects that will necessitate discontinuation of an oral contraceptive. Which statement made by the client indicates that the teaching is understood? "I'll stop taking the pills if I have chest pain." "I'll stop taking the pills if I start to retain fluid." "I'll stop taking the pills if I have white discharge from the vagina." "I'll stop taking the pills if I have pain in the middle of my cycle."

"I'll stop taking the pills if I have chest pain." Rationale: Oral contraceptives should be discontinued with any symptom that may be related to a pulmonary embolus. Fluid retention is a common side effect of increased estrogen and progestin; discontinuation of the contraceptive is unnecessary. Leukorrhea may be a sign of infection, not a side effect of oral contraceptives. Abdominal pain in the middle of the menstrual cycle is not expected while an oral contraceptive is being taken. Abdominal pain in the area of an ovary that occurs midway during the menstrual cycle (mittelschmerz) usually indicates ovulation.

An 8-year-old girl who is hospitalized for intravenous antibiotic therapy tells the nurse that she is bored. The nurse has a discussion with the father about appropriate activities. Which activity suggested by the father indicates a need for further teaching? "I'll bring a radio and CD player." "I'll bring homework and school supplies." "She'll enjoy having a rubber baseball and plastic bat." "She'll enjoy rubber stamps and a pretty box to keep them in."

"She'll enjoy having a rubber baseball and plastic bat." Rationale: Playing with a bat and ball is an unsafe activity in a hospital setting; the IV catheter could be dislodged, and boisterous activity is dangerous to the other children on the unit. A radio and CD player, homework and school supplies, and rubber stamps and a collection box are all appropriate for the school-aged child.

In the well-child clinic a nurse teaches a group of parents about guidelines that may prevent Reye syndrome in their preschool-aged children. What should the nurse tell the parents? 1. "Use a medication other than aspirin when your child has a fever. "2. "Restrict your child's carbohydrate intake when there are signs of a cold. "3. "Begin sponge bathing with cold water if your child experiences a high fever. "4. "You may want to have your child immunized with a recently developed vaccine."

1. "Use a medication other than aspirin when your child has a fever. Rationale: Reye syndrome is associated with viral infections, such as influenza or varicella, and commonly follows the ingestion of aspirin during the prodromal stage of these diseases. The child's metabolism is increased during illness; the child should have a high caloric intake. Cold-water sponge baths should not be used; the temperature may decrease too quickly and be too shocking for the child. There is no vaccine to prevent Reye syndrome.

A nurse teaches a client with a diagnosis of emphysema about the importance of preventing infections. What information is most significant to include? Purpose of bronchodilators Importance of meticulous oral hygiene Technique used in pursed-lip breathing Methods used to maintain a dust-free environment

Importance of meticulous oral hygiene Rationale: Microorganisms in the mouth are transferred easily to the tracheobronchial tree and are a source of potential infection; meticulous oral hygiene is essential to reduce the risk of respiratory infection. Bronchodilators will not prevent infection; they dilate the bronchi. Pursed-lip breathing will not prevent infection; it promotes gas exchange in the alveoli and facilitates more effective exhalation. It is impossible to maintain a dust-free environment.

A client is hospitalized with a diagnosis of emphysema. The nurse provides teaching and should begin with which aspect of care? The disease process and breathing exercises How to control or prevent respiratory infections Using aerosol therapy, especially nebulizers Priorities in carrying out everyday activities

The disease process and breathing exercises Rationale: Clients need to understand the disease process and how interventions, such as breathing exercises, can improve ventilation. Learning to control or prevent respiratory infections is important, but it should be taught later. Although it is helpful to know about aerosol therapy and nebulizers, knowing how to use aerosol therapy, especially nebulizers, should be taught later. Although it is important to teach the client how to set priorities in carrying out everyday activities, this should be taught later.