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
This statement is nontherapeutic because it shifts the focus away from the patient and onto the nurse’s personal experience. It can minimize the patient’s feelings and is not helpful in providing support.
Choice B rationale
Asking the patient to demonstrate how they give themselves insulin is a therapeutic communication technique. It shows interest in the patient’s self-care practices and provides an opportunity for the nurse to offer guidance and support.
Choice C rationale
This statement is nontherapeutic because it offers false reassurance. It does not address the patient’s concerns or provide any real support.
Choice D rationale
This statement is also nontherapeutic because it offers false reassurance and does not address the patient’s specific concerns or needs.
Correct Answer is B
Explanation
Choice A rationale
Serous chest tube drainage is a normal finding and does not typically indicate a complication. It is usually clear or pale yellow fluid that is expected after surgery.
Choice B rationale
Chest tube drainage of 200 mL in 1 hour is excessive and should be reported to the provider. This could indicate active bleeding or other complications that require immediate attention.
Choice C rationale
Fluctuation in the water-sealed chamber, also known as tidaling, is a normal finding and indicates that the chest tube is functioning properly. It reflects changes in pressure within the pleural space during respiration.
Choice D rationale
A respiratory rate of 22/min is within the normal range for a school-age child and does not typically indicate a complication.