You arrive for your morning 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 with complaints of severe hip pain and anorexia. His lab tests were normal with the exception of elevated liver enzymes. After an initial dose of Dilaudid 1 mg, he reports his pain as 2 on a 0 to 10 scale and has slept fitfully overnight.
Mr. Bradford, 5 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 three years ago, was admitted via the ER overnight with complaints 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 C
Choice A reason: Mr. Dominic's pain has been controlled to a manageable level, and although he experienced elevated liver enzymes, there are no acute symptoms requiring immediate intervention. He has been able to sleep, indicating that his current condition is stable.
Choice B reason: Mr. Bradford, although experiencing discomfort and blood-tinged urine, is post-surgical, and his condition is stable with managed output. Ambulating is a positive sign post-surgery, indicating recovery. His condition needs monitoring but is not the most urgent.
Choice C reason: Mr. Jennings, who had a TURBT yesterday, is experiencing bladder spasms and high volume irrigation. The output is almost equivalent to the input, which is a positive sign, but bladder spasms can indicate irritation, infection, or a blockage that needs prompt assessment and intervention to prevent further complications.
Choice D reason: Ms. Griffiths presents a similar case to Mr. Dominic, with controlled pain and elevated liver enzymes. She is stable overnight, and her pain level is low after medication, indicating her condition is currently managed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Intake and output are important for overall fluid balance but do not directly measure the reduction in ascites after a paracentesis.
Choice B reason: Measuring abdominal girth provides a direct and specific indication of the volume of fluid removed from the peritoneal cavity. A decrease in abdominal girth indicates that the procedure effectively reduced the ascites.
Choice C reason: Blood pressure can be influenced by many factors and does not specifically measure the outcome of a paracentesis.
Choice D reason: Cardiac output is related to heart function and is not a direct measure of the success of a paracentesis in removing ascitic fluid.
Correct Answer is B
Explanation
Choice A reason: Increasing need for pain medication is not a typical outcome expected when a client is educated about their new colostomy. Proper education can help manage and reduce pain through better understanding and care techniques. The objective is often to reduce discomfort by teaching clients how to care for their colostomy properly, thus reducing complications and the associated pain.
Choice B reason: Report of empowerment is the expected outcome. Education aims to make the client feel capable and confident in managing their new condition. Empowerment indicates that the client understands their condition and feels confident in their ability to manage their colostomy, which can improve their overall quality of life and reduce the psychological impact of the procedure. Empowerment also helps in reducing the dependency on healthcare professionals and promotes self-care.
Choice C reason: An increase in the length of care in the healthcare facility is not an expected outcome. Proper patient education should ideally reduce the length of stay in the healthcare facility by equipping the client with the knowledge and skills needed to manage their colostomy at home, thus reducing the need for prolonged hospital stays.
Choice D reason: Reporting of anxiety is not the desired outcome. While some initial anxiety might be expected, the goal of patient education is to reduce anxiety by providing the client with the necessary information and skills to feel confident in managing their colostomy. Effective education should help alleviate anxiety by addressing concerns and providing support and reassurance.
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