The client recovering from an esophagogastrectomy is preparing for discharge. What instructions should be included in the dietary teaching for this client?
Avoid high-protein food because they are irritating.
Avoid snacking in between meal times.
Maintain diet of pureed foods.
Lie flat after meals to prevent vomiting.
The Correct Answer is B
A. High-protein foods are not typically irritating after an esophagogastrectomy and are essential for healing and maintaining nutritional status. Clients should be encouraged to eat balanced meals with adequate protein.
B. Clients recovering from an esophagogastrectomy should avoid snacking between meals to prevent dumping syndrome, a common complication where food moves too quickly from the stomach to the small intestine. Instead, small, frequent meals should be consumed.
C. While pureed foods may be part of the immediate post-operative diet, the long-term goal is to gradually reintroduce solid foods, following the physician's dietary recommendations. A pureed diet is not necessarily required long-term.
D. Lying flat after meals increases the risk of reflux, which can be particularly harmful to clients recovering from esophageal surgery. Clients should be advised to stay upright after eating to aid digestion and prevent reflux.
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Correct Answer is B
Explanation
A. Bowel sounds, abdominal girth, and NG tube output provide important information about gastrointestinal function and the potential for complications like ileus or obstruction. However, they do not provide direct information regarding fluid volume status.
B. Vital signs (including blood pressure and heart rate), cardiac rhythm, and peripheral pulses are the first indicators to assess for decreased fluid volume. Hypovolemia often manifests as tachycardia, hypotension, and weak peripheral pulses, which are critical early signs of fluid depletion.
C. Blood Urea Nitrogen (BUN), creatinine, and daily weight are useful in assessing kidney function and long-term fluid status, but they may not be as immediate indicators of acute fluid volume changes in the immediate postoperative period.
D. Respiratory rate, depth, and pulse oximetry are important for assessing respiratory function and oxygenation. While fluid volume imbalances can impact respiratory function, these parameters are not the most direct indicators of fluid volume status.
Correct Answer is A
Explanation
A. Reaction time is slower in older adults due to changes in the central nervous system and decreased neuronal processing speed, which can impact their overall response to stimuli.
B. Pain sensation is not typically heightened in older adults; rather, they may experience a decreased sensitivity to pain due to changes in the nervous system.
C. Higher basal body temperature is generally not associated with aging; older adults often have a lower baseline temperature.
D. While confusion can occur in older adults, it is not considered a normal age-related change and should be further evaluated for underlying causes rather than being expected.