A patient is recuperating in the critical care unit following a cardiac catheterization.
IV nitroglycerin and heparin are being administered.
The patient is sedated but responds to verbal instructions.
After changing positions, the patient reports pain at the right groin insertion site.
What action should the nurse take?
Evaluate the integrity of the IV insertion site.
Encourage the patient to take deep breaths.
Assess distal lower extremity capillary refill.
Inspect the femoral site for hematoma formation.
The Correct Answer is D
Choice A rationale
Evaluating the integrity of the IV insertion site is important, but it does not directly address the patient’s complaint of pain at the right groin insertion site following a cardiac catheterization.
Choice B rationale
Encouraging the patient to take deep breaths can help with overall comfort and oxygenation, but it does not directly address the patient’s complaint of pain at the right groin insertion site following a cardiac catheterization.
Choice C rationale
Assessing distal lower extremity capillary refill can provide information about the patient’s overall circulation, but it does not directly address the patient’s complaint of pain at the right groin insertion site following a cardiac catheterization.
Choice D rationale
Inspecting the femoral site for hematoma formation is the most appropriate action in response to the patient’s complaint of pain at the right groin insertion site after a cardiac catheterization. Hematoma formation is a potential complication of this procedure and can lead to further complications if not addressed promptly. Ulcerative colitisUlcerative colitis Explore
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Related Questions
Correct Answer is B
Explanation
Choice A rationale
While it’s always important to inform the medical team of any allergies, there’s no specific link between shellfish or iodine allergies and cystoscopy.
Choice B rationale
After a cystoscopy, patients should report any instances of painful urination, blood in urine, or fever. These could be signs of complications such as infection.
Choice C rationale
There’s no specific need for patients to refrain from strenuous activities and sports for at least 2 weeks after a cystoscopy.
Choice D rationale
Remaining in a prone position for 24 hours after the procedure is not a standard recommendation following a cystoscopy.
Correct Answer is ["A","B","C","D"]
Explanation
D.
Choice A rationale
Administering morphine as prescribed would help to manage the patient’s reported pain.
Choice B rationale
Monitoring the patient’s vital signs is crucial in assessing the patient’s physiological response to the fall and ensuring stability.
Choice C rationale
Applying a cold pack to the affected area can help to reduce swelling and alleviate pain.
Choice D rationale
Arranging for an X-ray of the left shoulder would help to identify any potential fractures or other injuries resulting from the fall.
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