A nurse is providing instructions about a 24-hour urine collection to an adolescent client. Which of the following should the nurse include in the teaching?
Discard the first voided specimen.
Void every hour.
Save the final specimen in a separate container.
Cleanse the perineum with a povidone-iodine solution prior to voiding.
The Correct Answer is A
Choice A rationale
The first voided specimen is discarded to ensure that the 24-hour urine collection starts with an empty bladder and accurately reflects the urine produced over the entire period.
Choice B rationale
Voiding every hour is not necessary and may not be practical for a 24-hour urine collection.
Choice C rationale
The final specimen should be included in the same container as the rest of the 24-hour urine collection.
Choice D rationale
Cleansing the perineum with a povidone-iodine solution is not required for a 24-hour urine collection.
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Correct Answer is B
Explanation
Choice A rationale
Increased throat pain is common after a tonsillectomy and can be managed with pain relief measures. It is not the most critical finding.
Choice B rationale
Frequent swallowing can indicate bleeding at the surgical site, which is a serious complication that requires immediate attention.
Choice C rationale
Refusal to drink clear liquids is concerning for dehydration but is not as immediately critical as signs of bleeding.
Choice D rationale
Crying often can be due to pain or discomfort but is not as critical as signs of bleeding.
Correct Answer is D
Explanation
Choice A rationale
Encouraging flexion and extension of the neck is contraindicated for a client with a halo vest as it can compromise the stability of the cervical spine.
Choice B rationale
Assessing the pin sites for infection once every other day is not sufficient. Pin sites should be assessed at least once per shift to detect and manage any potential infections early.
Choice C rationale
Tightening the screws on the halo device one-quarter turn every 48 hours is not recommended. Adjustments to the halo device should only be made by a healthcare provider to ensure the integrity of the device and the stability of the cervical spine.
Choice D rationale
Repositioning the client using a turning sheet is the correct action. This method helps to reposition the client safely without exerting unnecessary pressure on the cervical spine and aids in preventing pressure ulcers.