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The nurse is planning care for a client with a direct (sliding) hiatal hernia. Nursing actions should be planned to meet which goal?

A.

Promote effective swallowing.

B.

Maintain intact oral mucosa.

C.

Prevent esophageal reflux.

D.

Increase intestinal peristalsis.

Answer and Explanation

The Correct Answer is C

Choice A rationale

 

Promoting effective swallowing is important for patients with dysphagia, but it is not the primary goal for a client with a sliding hiatal hernia. The main concern with a sliding hiatal hernia is the prevention of gastroesophageal reflux, which can lead to complications such as esophagitis and Barrett’s esophagus.

 

Choice B rationale

 

Maintaining intact oral mucosa is crucial for patients with conditions affecting the mouth, such as oral mucositis or infections. However, it is not the primary goal for a client with a sliding hiatal hernia. The focus should be on preventing reflux and managing symptoms.

 

Choice C rationale

 

Preventing esophageal reflux is the primary goal for a client with a sliding hiatal hernia. This condition occurs when the stomach slides up into the chest through the diaphragm, leading to gastroesophageal reflux disease (GERD). Nursing actions should aim to reduce reflux symptoms by advising the client to eat smaller meals, avoid lying down after eating, and elevate the head of the bed.

 

Choice D rationale

 

Increasing intestinal peristalsis is important for patients with conditions like constipation or ileus. However, it is not the primary goal for a client with a sliding hiatal hernia. The focus should be on preventing reflux and managing symptoms.


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View Related questions

Correct Answer is C

Explanation

Choice A rationale

Securing tracheostomy ties by making knots close to the tube can cause irritation and pressure on the skin.

Choice B rationale

Removing ties to secure a disposable, soft foam collar with hook and loop fastener is not the most important action when changing the ties of the tracheostomy tube.

Choice C rationale

Leaving the old ties in place until the new ones are secure is the most important action to prevent accidental dislodgement of the tracheostomy tube.

Choice D rationale

Placing knots of the ties laterally to prevent irritation and pressure is important but not the most critical action when changing the ties of the tracheostomy tube.

Correct Answer is C

Explanation

Choice A rationale

Monitoring daily urine output volume is important for assessing fluid balance, but it does not directly address the issue of hypernatremia. Hypernatremia is characterized by high sodium levels in the blood, and monitoring urine output alone will not help in managing sodium intake or identifying sources of excess sodium.

Choice B rationale

Using salt tablets after strenuous exercise is not recommended for clients with hypernatremia. Salt tablets can increase sodium levels further, exacerbating the condition. Hypernatremia requires careful management of sodium intake, and salt tablets would be counterproductive.

Choice C rationale

Reviewing food labels for sodium content is crucial for clients with hypernatremia. This helps them identify and avoid foods high in sodium, which can contribute to elevated sodium levels in the blood. Educating clients on reading food labels empowers them to make informed dietary choices and manage their condition effectively.

Choice D rationale

Drinking plenty of water whenever thirsty is a general recommendation for maintaining hydration, but it does not specifically address hypernatremia. Clients with hypernatremia need to focus on managing their sodium intake and ensuring they do not consume excessive amounts of sodium.

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