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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 D

Explanation

Choice A rationale

Laying down on each side with knees bent and breathing from the abdomen is not an effective technique for improving gas exchange in emphysema patients.

Choice B rationale

Increasing the breathing rate for a full 30 seconds can lead to hyperventilation and is not recommended for improving gas exchange.

Choice C rationale

Raising hands above the head to expand the diaphragm is not a recognized technique for improving gas exchange in emphysema patients.

Choice D rationale

Drawing air in through the nose and exhaling slowly through pursed lips is an effective technique for improving gas exchange in emphysema patients. This method helps to keep the airways open longer and improves the removal of trapped air.

Correct Answer is A

Explanation

Choice A rationale

Corneal abrasion is a contraindication for the use of ophthalmic ketorolac. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can delay healing and increase the risk of further damage to the cornea.

Choice B rationale

Chemical burns are not a primary contraindication for ophthalmic ketorolac. However, the treatment of chemical burns typically involves other specific interventions, and the use of ketorolac should be carefully considered.

Choice C rationale

Radiation exposure is not a direct contraindication for the use of ophthalmic ketorolac. The medication is used to reduce inflammation and pain, which may be beneficial in managing symptoms related to radiation exposure.

Choice D rationale

A foreign body in the eye is not a primary contraindication for ophthalmic ketorolac. However, the foreign body should be removed, and the eye should be thoroughly examined before administering any medication.

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