Following a lumbar puncture, a client voices several concerns. Which concern indicates to the nurse that the client is experiencing a complication of the procedure?
"I have a headache that gets worse when I sit up."
"I am having pain in my lower back when I move my legs."
"I feel sick to my stomach and am going to throw up."
"My throat hurts badly when I swallow and when I talk."
The Correct Answer is A
A. A headache that worsens upon sitting up is characteristic of a post-lumbar puncture headache, indicating a potential complication related to cerebrospinal fluid leakage.
B. Pain in the lower back after the procedure can be normal and does not necessarily indicate a complication.
C. Nausea and vomiting can occur but are not specific indicators of a complication following a lumbar puncture.
D. Sore throat when swallowing and talking is not typically associated with lumbar puncture complications and may relate to other causes such as anxiety or dehydration.
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Correct Answer is D
Explanation
A. Visible swelling of the neck may indicate other conditions, such as thyroid issues, but it is not a characteristic finding of Cushing's syndrome.
B. Warm, soft, moist, salmon-colored skin is more indicative of hyperthyroidism rather than Cushing's syndrome, which typically presents with thin, fragile skin.
C. A husky voice and hoarseness can occur due to various reasons, but they are not classic symptoms of Cushing's syndrome.
D. Central type obesity, characterized by a rounded face and thin extremities, is a hallmark feature of Cushing's syndrome, caused by excessive cortisol levels leading to fat redistribution.
Correct Answer is B
Explanation
A. Internal bleeding typically presents with signs of hypovolemia, such as decreased blood pressure and increased heart rate, rather than pitting edema and jugular venous distention.
B. Right-sided heart failure is characterized by fluid overload, leading to symptoms like pitting edema in the extremities and jugular venous distention, which align with the findings observed in this client.
C. Left ventricular dysfunction primarily results in pulmonary congestion and respiratory distress rather than peripheral edema and jugular venous distention.
D. Cardiac tamponade may present with jugular venous distention, but it usually also involves hypotension and muffled heart sounds, which are not described in this scenario.