Which of the following post-surgical clients warrant an immediate follow up by the nurse? (Select all that apply.)

Patient with lung surgery has 20 ml/hr of urine output via catheter.

Patient with appendix surgery has thready pulse and blood pressure is 90/60.

Patient with knee surgery has approximated incision.

Patient with femoral artery surgery has strong pedal pulse.

Patient with bladder surgery has bloody urine within the first 12 hours.

Answer and Explanation

Correct Answer : A,B,E

A.   A urine output of 20 ml/hr is considered inadequate and may indicate decreased kidney perfusion or function. This client likely needs immediate assessment and intervention to address potential renal complications.
B.   A patient with appendix surgery exhibiting a thready pulse and a blood pressure of 90/60 should be followed up immediately, as these signs can indicate shock, which is a medical emergency.
C.   An approximated incision indicates that the wound edges are well-aligned and healing is progressing as expected. This does not typically warrant immediate follow-up unless there are signs of infection or other complications.
D.   A strong pedal pulse suggests adequate blood flow distal to the surgical site. This is a positive finding and does not typically require immediate follow-up unless there are signs of vascular compromise or other complications.
E.   A patient with bladder surgery having bloody urine within the first 12 hours can be expected, but if the bleeding is heavy or increases, it would warrant immediate follow-up.

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Correct Answer is ["167"]

Explanation

1 kilogram is equivalent to 2.2 pounds.

The client weighs 245 lbs, which is approximately 111.36 kg (245 lbs / 2.2). The prescribed dosage is 1.5 mg per kilogram.

Therefore, the dosage per dose would be 1.5 mg/kg * 111.36 kg, which equals 167.04 mg. Rounded to the nearest whole number, the nurse should administer 167 mg per dose.

A. Metabolic alkalosis B. Respiratory alkalosis C. Metabolic acidosis D. Respiratory acidosis

Correct Answer is D

Explanation

A. Metabolic alkalosis is characterized by an increase in bicarbonate (HCO3-) levels in the blood, resulting in an elevated pH (>7.45). Shallow respirations are less likely to cause metabolic alkalosis directly.
B. This is not likely the initial risk. Respiratory alkalosis occurs due to hyperventilation, leading to excessive elimination of CO2 (carbon dioxide), which raises the blood pH (>7.45). Shallow respirations typically result in retention of CO2, leading to respiratory acidosis rather than alkalosis.
C. Metabolic acidosis occurs when there is an increase in acid (decreased pH <7.35) or a decrease in bicarbonate levels in the blood. Shallow respirations can lead to hypoventilation and retention of CO2, resulting in respiratory acidosis initially.
D. Shallow respirations at a rate of 9 breaths per minute reduce the elimination of CO2, leading to its accumulation in the blood. This accumulation lowers the blood pH (<7.35), causing respiratory acidosis. Therefore, the client is initially at risk for developing respiratory acidosis due to ineffective ventilation.

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Which of the following post-surgical clients warrant an immediate follow up by the nurse? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["167"]

Explanation

A nurse is caring for a client who is postoperative and whose respirations are shallow and 9/min. Which of the following acid-based imbalances should the nurse identify the client as being at risk for developing initially?

Correct Answer is D

Explanation

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