A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram.

Which instruction should the nurse include in the client’s discharge instructions?

Use an incentive spirometer.

Monitor the urinary stream for decreased output.

Restrict physical activities.

Report when hematuria becomes pink-tinged.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Using an incentive spirometer is generally recommended for respiratory conditions to improve lung function, not specifically for a client with hydronephrosis and a history of renal calculi.
Choice B rationale
Monitoring the urinary stream for decreased output is crucial for a client with hydronephrosis and a history of renal calculi. Hydronephrosis is a condition characterized by urine accumulation in the kidney, which can lead to decreased urine output. Therefore, monitoring urinary output can help detect any potential complications or worsening of the condition.
Choice C rationale
Restricting physical activities is not typically necessary for a client with hydronephrosis and a history of renal calculi unless specified by the healthcare provider. It’s more important to focus on maintaining overall health and well-being.
Choice D rationale
Reporting when hematuria becomes pink-tinged is not the most relevant instruction for a client with hydronephrosis and a history of renal calculi. While it’s important to report any changes in urine color, monitoring urinary output (Choice B) is more directly related to the client’s condition.

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Correct Answer is A

Explanation

Notifying the healthcare provider of the client’s medication history is the priority nursing action. Heparin is an anticoagulant, which increases the risk of bleeding. The healthcare provider needs this information to make appropriate decisions about the client’s surgical plan and postoperative care.

A. Keep the head of the bed elevated until the treatment is completed. B. Instruct the client to drink plenty of fluids during the treatment. C. Monitor the client’s intravenous site hourly during the treatment. D. Administer an antiemetic before starting the chemotherapy.

Correct Answer is C

Explanation

Choice A rationale
Keeping the head of the bed elevated until the treatment is completed is not typically recommended to reduce the risk of vesicant extravasation during intravenous chemotherapy.
Choice B rationale
Instructing the client to drink plenty of fluids during the treatment does not directly reduce the risk of vesicant extravasation. Hydration can help maintain good vein health, but it does not prevent extravasation.
Choice C rationale
Monitoring the client’s intravenous site hourly during the treatment is a key action to reduce the risk of vesicant extravasation. Regular monitoring allows for early detection of any signs of extravasation, such as swelling or redness at the IV site.
Choice D rationale
Administering an antiemetic before starting the chemotherapy can help manage side effects such as nausea and vomiting, but it does not reduce the risk of vesicant extravasation.

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A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram. Which instruction should the nurse include in the client’s discharge instructions?

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Correct Answer is A

Explanation

Which action should the nurse implement to reduce the risk of vesicant extravasation in the client who is receiving intravenous chemotherapy?

Correct Answer is C

Explanation

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A client with right hydronephrosis and a history of renal calculi is preparing for discharge following a retrograde pyelogram.

Which instruction should the nurse include in the client’s discharge instructions?