A nurse is evaluating a client who had a left-sided cardiac catheterization with an upper extremity insertion site.
Which of the following actions should the nurse take?
Encourage the client to ambulate within 30 min following the procedure.
Keep the client NPO for at least 2 hr following the procedure.
Assess pulses in the client's affected arm.
Apply light pressure to the insertion site.
The Correct Answer is C
Choice A rationale
Encouraging the client to ambulate within 30 minutes following the procedure is not recommended as it could lead to complications such as bleeding or hematoma at the insertion site.
Choice B rationale
Keeping the client NPO for at least 2 hours following the procedure is not typically necessary and does not relate directly to the care required after a cardiac catheterization.
Choice C rationale
Assessing pulses in the client's affected arm is crucial to ensure that there is adequate blood flow and no compromise in circulation following the procedure.
Choice D rationale
Applying light pressure to the insertion site may help in preventing bleeding initially, but it is more critical to monitor for signs of bleeding or hematoma formation over time. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While heartburn can occur shortly after eating, it is the frequent episodes of heartburn and regurgitation that are more commonly associated with hiatal hernia.
Choice B rationale
Dysphagia (difficulty swallowing) and odynophagia (painful swallowing) can occur with other esophageal conditions but are not the primary symptoms of hiatal hernia.
Choice C rationale
Frequent bouts of heartburn and regurgitation after food intake are classic symptoms of hiatal hernia, due to the herniation of the stomach through the diaphragm allowing acid to reflux into the esophagus.
Choice D rationale
Bloating and postprandial fullness can occur, but they are not as commonly associated with hiatal hernia as heartburn and regurgitation.
Correct Answer is D
Explanation
Choice A rationale
Irrigating the catheter without checking for kinks first may not address the underlying issue and can potentially cause harm.
Choice B rationale
Adjusting the rate of the bladder irrigant may not resolve the issue if the catheter tubing is kinked.
Choice C rationale
Notifying the provider without first checking for kinks may delay the resolution of the problem.
Choice D rationale
Checking the tubing for kinks is the first action to ensure there is no obstruction preventing the flow of urine. .
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