You arrive for your 7 a.m. shift on the urology unit and the night nurse gives a report on the following patients who will be under your care. Which one would you see first?
Mr. Dominic, newly admitted for evaluation of bladder cancer.
Mr. Bradford is 3 days post-radical prostatectomy for invasive bladder cancer. His urine output overnight was 1200 mL of blood-tinged urine. He did not sleep well and ambulated twice overnight complaining of gas pains.
Mr. Jennings had a TURBT (transurethral resection of bladder tumor) yesterday. He is complaining of bladder spasms. He had 3000 mL of bladder irrigation in overnight and 2950 mL out.
Ms. Griffiths, who had a cystectomy for bladder cancer 3 years ago, was admitted via the ER overnight with a complaint of severe hip pain and anorexia. Her lab tests were normal with the exception of elevated liver enzymes. After an initial dose of Dilaudid 1 mg, she reports her pain as 2 on a 0 to 10 scale and has slept fitfully overnight.
The Correct Answer is B
Choice A reason: Mr. Dominic's evaluation for bladder cancer is important, but there are no acute symptoms reported that require immediate attention over the other patients listed.
Choice B reason: Mr. Bradford's condition is the most concerning. He is 3 days post-radical prostatectomy with significant blood-tinged urine output and complaints of gas pains, which could indicate complications such as bleeding or infection that need immediate assessment.
Choice C reason: Mr. Jennings’ condition is stable with an almost equal in-and-out bladder irrigation, though bladder spasms should be addressed, it is not as immediately critical as Mr. Bradford's symptoms.
Choice D reason: Ms. Griffiths is stable with managed pain levels and normal lab results except for elevated liver enzymes, which do not present an immediate threat compared to Mr. Bradford's condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Wearing an external collection bag is typically associated with other types of urinary diversions, such as an ileal conduit, not a neobladder.
Choice B reason: A neobladder involves the creation of an internal pouch from a segment of the intestine that stores urine and allows for more natural urination, similar to the function of a natural bladder. This option provides the ability to void through the urethra.
Choice C reason: While some initial incontinence can occur after neobladder surgery, the goal is to eventually have voluntary control over urination with time and practice.
Choice D reason: Having a stoma located in the abdomen is characteristic of an ileal conduit or urostomy, not a neobladder. The neobladder is designed to avoid the need for an external stoma.
Correct Answer is B
Explanation
Choice A reason: Increasing the intake of raw vegetables is not typically recommended immediately after colostomy surgery due to the potential for causing gas and irritation in the bowel. A more balanced diet should be gradually introduced.
Choice B reason: It is common to experience a small amount of bleeding around the stoma initially as it heals. This is normal and should subside as the healing process continues.
Choice C reason: Fecal output usually begins within 2-4 days after surgery, not necessarily within 24 hours. The bowel needs time to adjust and start functioning properly after the operation.
Choice D reason: The stoma should be pink to red and moist, indicating healthy tissue. A purplish color may indicate compromised blood flow and requires immediate medical attention.
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