A nurse is assisting with the care of a client following a cerebral angiography. Which of the following actions should the nurse take?

Apply a warm pack to the client's puncture site.

Monitor for bleeding at the catheter site.

Replace the client's pressure dressing in 2 hr.

Encourage the client to ambulate in 1 hr.

Answer and Explanation

The Correct Answer is B

A. Apply a warm pack to the client's puncture site. Applying a warm pack to the puncture site is not appropriate immediately following cerebral angiography. Cold compresses are generally recommended initially to reduce swelling and discomfort, while warmth may be used later as advised by the healthcare provider.
B. Monitor for bleeding at the catheter site. Monitoring for bleeding at the catheter site is a critical action after cerebral angiography. The nurse should assess the site frequently for signs of hematoma or excessive bleeding, which can indicate complications from the procedure.
C. Replace the client's pressure dressing in 2 hr. The pressure dressing should not be replaced without specific orders from the healthcare provider. The nurse should assess the dressing for any signs of bleeding or drainage and follow the protocol for dressing changes as indicated.
D. Encourage the client to ambulate in 1 hr. Early ambulation may not be safe immediately after cerebral angiography, especially if the client has undergone a procedure involving sedation or if there is a risk of complications. The nurse should follow the provider's orders regarding activity restrictions and assess the client's readiness for ambulation based on their condition and vital signs.

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Correct Answer is B

Explanation

A. Hypotension: Gentamicin is an aminoglycoside antibiotic that primarily affects the kidneys and auditory system rather than blood pressure. Hypotension is not a common adverse effect of gentamicin; however, dehydration related to nephrotoxicity could contribute to blood pressure fluctuations.
B. Hearing loss: Ototoxicity is a known adverse effect of gentamicin due to its accumulation in the inner ear, leading to damage of the cochlear and vestibular structures. Clients may report tinnitus, dizziness, or difficulty hearing, and prolonged exposure increases the risk of irreversible auditory impairment.
C. Hyperthermia: Fever is typically a sign of infection rather than an adverse effect of gentamicin. While aminoglycosides can cause fever in rare cases due to a drug-induced reaction, hyperthermia is not a common side effect and should prompt evaluation for worsening infection or another underlying cause.
D. Constipation: Gentamicin does not significantly affect gastrointestinal motility. While some antibiotics may cause gastrointestinal upset, nausea, or diarrhea, constipation is not a recognized adverse effect of gentamicin therapy.

A. Diminished hearing B. Pupils C. Lung assessment D. Facial nerve assessment E. Vertigo F. Pain rating

Correct Answer is ["D","E","F"]

Explanation

A. Diminished hearing. Hearing loss following a stapedectomy is expected due to postoperative swelling, packing in the ear, and fluid accumulation. Hearing typically improves as healing progresses. This does not require further action by the nurse.
B. Pupils. The preoperative and postoperative pupil assessments are similar (3.5 mm preoperatively and 3 mm postoperatively), and both are equal and reactive to light. No significant neurological change is noted, so this does not require further action.
C. Lung assessment. The lungs were clear bilaterally preoperatively, and there is no indication of respiratory compromise or abnormal lung sounds postoperatively. This does not require further action.
D. Facial nerve assessment. Facial nerve injury (cranial nerve VII dysfunction) is a potential complication of stapedectomy. The nurse should assess for asymmetry in facial movements such as difficulty smiling or drooping, weakness, or numbness, which could indicate facial nerve damage. This requires further action.
E. Vertigo. Postoperative vertigo and dizziness can occur due to disturbance of the inner ear during surgery. Severe or persistent vertigo may indicate labyrinthine injury or perilymph fistula, which could require medical intervention. This requires further action.
F. Pain rating. Postoperative pain is expected, but severe or increasing pain may indicate complications such as infection, excessive pressure in the middle ear, or improper prosthesis placement. Pain that is not relieved by analgesics requires further evaluation. This requires further action.

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A nurse is assisting with the care of a client following a cerebral angiography. Which of the following actions should the nurse take?

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