A nurse is reinforcing teaching with a client who needs to have a cholecystectomy due to gallstones. Which of the following is the best response from the nurse to explain what caused this problem?
The gallbladder became infected by a virus and needs to be removed.
The gallbladder has become inflamed due to the cholesterol in the gallstones,
The gallbladder has become blocked by a tumor and is no longer working.
The gallbladder has become inflamed due to a build-up of gallstones that are blocking the common bile duct.
The Correct Answer is B
A. The gallbladder became infected by a virus and needs to be removed. Gallstones are not caused by viral infections; they typically develop from an imbalance in the substances that make up bile, such as cholesterol and bilirubin.
B. The gallbladder has become inflamed due to the cholesterol in the gallstones. Cholesterol is a common component of gallstones, and these stones can cause inflammation of the gallbladder (cholecystitis), leading to the need for removal.
C. The gallbladder has become blocked by a tumor and is no longer working. Tumors can obstruct the gallbladder, but this is not the cause of gallstones or the primary reason for a cholecystectomy.
D. The gallbladder has become inflamed due to a build-up of gallstones that are blocking the common bile duct. This describes choledocholithiasis, a condition where gallstones block the common bile duct, but it is not the primary cause of gallbladder inflammation requiring a cholecystectomy.
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Correct Answer is A
Explanation
A. Reduction of inflammation and suppression of immune responses. Methylprednisolone is a corticosteroid that reduces inflammation and suppresses immune responses, which can help manage the acute exacerbations of MS.
B. Stimulation of nerve regeneration. Methylprednisolone does not stimulate nerve regeneration; it focuses on reducing inflammation.
C. Improvement in cognitive function. Cognitive improvement is not a primary goal of methylprednisolone in MS management, though reducing inflammation may indirectly benefit cognition.
D. Increase in muscle strength and coordination. While reducing inflammation can improve symptoms, methylprednisolone itself does not directly increase muscle strength or coordination.
Correct Answer is A
Explanation
A. Administering mannitol intravenously: Mannitol is an osmotic diuretic that helps reduce ICP by drawing fluid out of brain tissue and decreasing cerebral edema, making it a priority intervention.
B. Encouraging the patient to hyperventilate: Controlled hyperventilation may reduce ICP temporarily by lowering CO₂ levels and causing cerebral vasoconstriction. However, it should only be done cautiously under close monitoring, and other ICP management techniques like mannitol administration take priority.
C. Administering a high-dose corticosteroid: Corticosteroids are generally ineffective for reducing ICP in traumatic brain injury and are typically not recommended in this scenario.
D. Performing a lumbar puncture immediately: Lumbar puncture is contraindicated in cases of increased ICP because it may lead to brain herniation due to the sudden release of pressure.