A client is scheduled for transsphenoidal microsurgery for removal of a pituitary adenoma. Which preoperative instruction should the nurse include?
1. The client may not use a toothbrush for several days after surgery to prevent injury to the surgical site.
2. Turn, deep breathe and cough every 2 hours.
3. The client must remain supine in bed, with sandbags alongside her head to prevent movement.
4. The client will have to take replacement growth hormone for the rest of her life.
Answer: 1
1. Tooth brushing could disrupt the incision, which is in the roof of the mouth.
2. Coughing increases intracranial pressure.
3. A semi-Fowler's to Fowler's position facilitates breathing.
4. Lifelong replacement of pituitary hormones is necessary.
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