The nurse is providing discharge instructions to a patient who is recovering from anal-rectal surgery for repair of an anal fissure. What should be included in these instructions?
Select all that apply.
1. Do not remove the dressing.
2. Change the dressing if it becomes soiled with urine or feces.
3. Use the sitz bath.
4. Use the antibiotic until all drainage stops.
5. Avoid bowel movements.
Correct Answer: 2, 3
Teach the importance of maintaining a high-fiber diet and liberal fluid intake to increase stool bulk and softness and thereby decrease discomfort with defecation. Stress the importance of responding to the urge to defecate to prevent constipation. Teach the patient to keep the perianal region clean and dry. If a dressing is in place, instruct to avoid soiling it with urine or feces during elimination. Following removal of the dressing, teach to clean the area gently with soap and water following a bowel movement. Discuss the use of sitz baths for cleaning and comfort. If an antibiotic has been prescribed, provide written and verbal instructions about its use, its desired effects, and possible adverse effects and their management.
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A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?
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