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 B

Explanation

Choice A rationale
While monitoring skin for breakdown is an important aspect of nursing care, especially for bedridden or immobile patients, it is not the most important intervention for a client admitted with possible anastomosis leakage.
Choice B rationale
An anastomotic leak is a serious complication that occurs when the surgical connection between two parts of the intestine leaks, allowing the contents of the gastrointestinal tract to leak into the abdominal cavity. This can lead to serious infection and sepsis. Strict intravenous
(IV) fluid replacement is crucial in this situation to prevent dehydration and maintain blood pressure.
Choice C rationale
Encouraging regular turning is an important aspect of nursing care to prevent pressure ulcers, especially for bedridden or immobile patients. However, it is not the most important intervention for a client admitted with possible anastomosis leakage.
Choice D rationale
Assessing wound drainage daily is an important aspect of postoperative care. However, in the case of a suspected anastomotic leak, more immediate and critical interventions are required.

A. White blood cell count. B. Platelet count. C. Red blood cell count. D. Hemoglobin levels.

Correct Answer is B

Explanation

Choice A rationale
While a white blood cell count can indicate an infection or inflammation in the body, it’s not the most relevant laboratory result to review when a client presents with petechiae and ecchymosis. These symptoms are more commonly associated with platelet disorders or coagulation issues.
Choice B rationale
A platelet count is the most relevant laboratory result to review for a client with petechiae and ecchymosis. These symptoms are often caused by low platelet counts, which can lead to bleeding and bruising. Therefore, reviewing the platelet count can provide valuable information about the client’s condition.
Choice C rationale
A red blood cell count can provide information about the client’s overall health and can indicate conditions like anemia. However, it’s not directly related to the presence of petechiae and ecchymosis.
Choice D rationale
Hemoglobin levels can indicate conditions like anemia, but they’re not directly related to the presence of petechiae and ecchymosis. These symptoms are more commonly associated with platelet disorders or coagulation issues.

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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 B

Explanation

The nurse assesses a client with petechiae and ecchymosis scattered across the arms and legs. Which laboratory result should the nurse review?

Correct Answer is B

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?