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 C

Explanation

A. A hematocrit of 40% is within the normal range for females, which is typically around 37-47%. This result is not concerning and does not typically require immediate notification to the surgeon.
B. A creatinine level of 0.9 mg/dL is within the normal range for adults (normal range varies slightly among laboratories but is generally around 0.5-1.1 mg/dL). This result indicates normal kidney function and does not require immediate notification.
C. A white blood cell (WBC) count of 20,000/mm3 is elevated above the normal range, which is typically between 4,500-11,000/mm3. An elevated WBC count could indicate infection or inflammation. Given the client is preoperative, an elevated WBC count may suggest an underlying infection that needs to be addressed before proceeding with surgery. The nurse should notify the surgeon promptly so appropriate evaluation and management can be initiated.
D. A potassium level of 3.8 mEq/L is within the normal range (normal range is generally 3.5-5.0 mEq/L). This result is not concerning and does not require immediate notification to the surgeon.

A. Metformin B. Carvedilol C. Atorvastatin D. Nitroglycerin

Correct Answer is A

Explanation

A. Metformin is an oral antidiabetic medication commonly used to manage type 2 diabetes mellitus. It can cause a rare but serious side effect called lactic acidosis, especially in situations where there is impaired kidney function or when the drug interacts with contrast dye used in procedures like cardiac catheterization.
B. Carvedilol is a beta-blocker used to manage hypertension and heart failure. It does not have a significant interaction with contrast dye that would increase the risk of AKI.
C. Atorvastatin is a statin medication used to lower cholesterol levels. It does not interact with contrast dye in a way that increases the risk of AKI.
D. Nitroglycerin is a vasodilator used to relieve angina symptoms. It does not interact with contrast dye in a way that increases the risk of AKI.

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

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

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