A nurse is caring for four postoperative clients who each had a ...

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A nurse is caring for four postoperative clients who each had a total abdominal hysterectomy. Which client should the nurse assess first upon initial rounding?
 
  a. Client who has had two saturated perineal pads in the last 2 hours
  b. Client with a temperature of 99  F and blood pressure of 115/73 mm Hg
  c. Client who has pain of 4 on a scale of 0 to 10
  d. Client with a urinary catheter output of 150 mL in the last 3 hours

Question 2

A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best?
 
  a. Suggest increasing vitamins and supplements daily.
  b. Discuss the value of a balanced diet and exercise.
  c. Reinforce that weight gain may be inevitable.
  d. Teach that estrogen cream inserted vaginally may help.

[Viet Thy]

Answer to Question 1

ANS: A
Normal vaginal bleeding should be less than one saturated perineal pad in 4 hours. Two saturated pads in such a short time could indicate hemorrhage, which is a priority. The other clients also have needs, but the client with excessive bleeding should be assessed first.

Answer to Question 2

ANS: D
Use of vaginal estrogen cream and gentle dilation can help with vaginal changes and loss of libido. Weight gain and masculinization are misperceptions after a vaginal hysterectomy. Vitamins, supplements, a balanced diet, and exercise are helpful for healthy living, but are not necessarily going to increase libido.