The nurse is caring for a client who has a peptic ulcer that is actively bleeding. Which finding would the nurse Immediately report to the physician?

hemoglobin 7.8

blood pressure = 118/78

occult blood in stool

epigastric pain that is worse on palpation

Answer and Explanation

The Correct Answer is A

A. Hemoglobin 7.8: This finding indicates a low hemoglobin level, which suggests significant blood loss, likely due to the actively bleeding peptic ulcer. Hemoglobin levels below normal can indicate anemia, and a level of 7.8 is particularly concerning. This finding should be immediately reported to the physician because it suggests ongoing bleeding and the need for intervention to stabilize the client's hemoglobin levels and prevent further complications such as hypovolemic shock.
B. Blood pressure = 118/78: This blood pressure reading falls within the normal range for most adults. While monitoring blood pressure is important, this finding alone may not be immediately concerning in the context of a bleeding peptic ulcer.
C. The presence of occult blood in the stool suggests gastrointestinal bleeding, which is consistent with the actively bleeding peptic ulcer. While this finding is significant, it may not require immediate reporting to the physician as it is expected in the context of the client's condition.
D. Epigastric pain is a common symptom of peptic ulcer disease, and worsening pain on palpation may indicate peritonitis or perforation, which are serious complications of peptic ulcers. However, if the pain is severe or associated with signs of peritonitis it should be promptly reported to the physician for further evaluation and management.

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Correct Answer is B

Explanation

B. After ESWL for a urinary stone, it is essential to monitor the client's urine characteristics (such as color, clarity, and presence of blood) and output. The presence of hematuria is a common and expected finding after ESWL due to the disruption of tissue and blood vessels during the procedure. Monitoring urine output helps assess renal function and ensures adequate hydration, which is crucial for flushing out stone fragments.
A. While monitoring urine specific gravity can provide information about the concentration of urine, and assessing antigen levels may be relevant in certain contexts, these parameters are not typically the most important information to collect immediately after extracorporeal shock-wave lithotripsy (ESWL) for a urinary stone.
C. While it is important to monitor the surgical site for signs of infection or complications after any procedure, ESWL is a non-invasive procedure performed externally, typically without any incisions.
D. While obtaining clean catch urine specimens for urinalysis and culture may be relevant for assessing urinary tract infection or other urinary abnormalities, it is not typically the most important information to collect immediately after ESWL.

A. "Frequency is greater in the northern United States." B. "Fluid excess is implicated in many cases of renal stones." C. "Diet plays a role in the formation of some types of stones." D. "Women have a greater risk overall than men."

Correct Answer is C

Explanation

C. Dietary factors, such as high intake of certain foods (e.g., animal protein, sodium, oxalate-rich foods) and low intake of others (e.g., fluids, calcium), can influence the composition of urine and contribute to the formation of renal stones. For example, calcium oxalate stones can form when there is an imbalance of calcium and oxalate in the urine, while uric acid stones can form in individuals with high purine diets.
A. The frequency of renal stones can vary depending on factors such as climate, dietary habits, and genetic predisposition, but it is not specifically associated with the northern United States.
B. Dehydration and inadequate fluid intake can contribute to the formation of renal stones, particularly calcium-based stones. Insufficient fluid intake can lead to concentrated urine, which increases the risk of stone formation and not vice versa.
D. The risk of renal stones is equal in both men and women.

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The nurse is caring for a client who has a peptic ulcer that is actively bleeding. Which finding would the nurse Immediately report to the physician?

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