Following a ureterolithotomy, the client has a ureteral catheter in place. Which intervention should the nurse implement?

Evaluate amount of urinary output hourly.

Clamp the catheter for 5 minutes hourly.

Secure the ureteral catheter to the client’s leg.

Report urine leakage around ureteral catheter.

Answer and Explanation

The Correct Answer is D

Choice A reason: Evaluating urinary output hourly monitors renal function post-ureterolithotomy, as obstruction or complications may reduce output. However, urine leakage around the catheter suggests dislodgement or ureteral injury, risking peritonitis or infection. Reporting leakage is more urgent, as it indicates a critical catheter malfunction requiring immediate medical attention.

Choice B reason: Clamping the ureteral catheter risks obstructing urine flow, increasing pressure and causing ureteral damage or reflux, potentially leading to hydronephrosis or infection. Leakage around the catheter is a more pressing issue, indicating possible perforation or displacement, necessitating urgent reporting to prevent severe complications.

Choice C reason: Securing the catheter prevents dislodgement but is routine. Urine leakage suggests a critical issue like catheter malfunction or ureteral injury, which could cause peritonitis or fistula. Reporting leakage takes precedence, as it addresses a potentially life-threatening complication, ensuring timely intervention over standard catheter care.

Choice D reason: Reporting urine leakage is critical, as it may indicate catheter displacement or ureteral perforation, risking peritonitis or infection. Leakage suggests the catheter fails to drain urine properly, a serious post-surgical issue requiring immediate assessment, potentially via imaging or surgical correction, to prevent renal or systemic complications.

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Correct Answer is B

Explanation

Choice A reason: Inserting a small bore tube for enteral feedings is inappropriate for acute GERD exacerbation, as feeding increases gastric volume, worsening reflux by raising pressure and acid exposure. Proton pump inhibitors (PPIs) reduce acid production, alleviating mucosal irritation, addressing GERD’s pathophysiology more effectively than nutritional interventions.

Choice B reason: Intravenous PPIs (e.g., pantoprazole) are standard for severe GERD, inhibiting H+/K+-ATPase in parietal cells, reducing acid secretion. This promotes esophageal healing when oral famotidine fails. IV delivery ensures rapid onset, critical for controlling worsening symptoms, preventing complications like esophagitis or Barrett’s esophagus in acute settings.

Choice C reason: Total parenteral nutrition (TPN) bypasses the gut, used for conditions like bowel obstruction, not GERD, which involves acid reflux from sphincter dysfunction. TPN does not address acid production. PPIs target the pathophysiological cause, reducing esophageal acid exposure, making TPN irrelevant for GERD management.

Choice D reason: A nasogastric tube with suction removes gastric contents but does not treat GERD’s acid reflux, caused by lower esophageal sphincter dysfunction. It risks aspiration and is temporary. PPIs effectively reduce acid, preventing esophageal damage, making them the preferred treatment for severe GERD exacerbation.

A. “I should avoid activities that increase eye pressure, like heavy lifting.” B. “Glaucoma can lead to vision loss if not managed properly.” C. “Eye drops will cure my glaucoma and restore my vision.” D. “Regular eye exams are important to monitor my condition.”

Correct Answer is C

Explanation

Choice A reason: Avoiding heavy lifting is correct, as it increases intraocular pressure (IOP) in glaucoma, damaging the optic nerve. This statement shows understanding, as limiting activities that elevate IOP protects retinal ganglion cells, reducing progression risk, aligning with proper glaucoma management strategies.

Choice B reason: Glaucoma can cause vision loss if untreated, as elevated IOP damages optic nerve fibers, leading to irreversible blindness. This statement reflects accurate understanding of the disease’s progressive nature, emphasizing the need for management to preserve vision, requiring no further teaching.

Choice C reason: Eye drops (e.g., timolol) reduce IOP but do not cure glaucoma or restore vision, as optic nerve damage is irreversible. This statement indicates misunderstanding, as glaucoma is chronic, requiring lifelong management to slow progression, necessitating further teaching to correct this misconception.

Choice D reason: Regular eye exams monitor IOP and optic nerve health in glaucoma, preventing progression. This statement shows understanding, as consistent follow-up detects changes in retinal nerve fiber layer thickness, ensuring timely adjustments in therapy, aligning with effective disease management.

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Following a ureterolithotomy, the client has a ureteral catheter in place. Which intervention should the nurse implement?

Nursing Test Bank

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