Nokea
A patient who has recently undergone ESWL for the treatment of renal calculi has phoned the urology unit where he was treated, telling the nurse that he has a temperature of101.1 \mathrm{~F}(38.4 \mathrm{C})$. How should the nurse best respond to the patient?
- A. Remind the patient that renal calculi have a noninfectious etiology and that a fever is unrelated to their recurrence.
- B. Remind the patient that occasional febrile episodes are expected following ESWL.
- C. Tell the patient to report to the ED for further assessment.
- D. Tell the patient to monitor his temperature for the next 24 hours and then contact his urologists office.
Correct Answer: C
Rationale: Following ESWL, the development of a fever is abnormal and is suggestive of a UTI; prompt medical assessment and treatment are warranted. It would be inappropriate to delay further treatment.
You may also like to solve these questions
The nurse is caring for a patient who has undergone creation of a urinary diversion. Forty-eight hours postoperatively, the nurses assessment reveals that the stoma is a dark purplish color. What is the nurses most appropriate response?
- A. Document the presence of a healthy stoma.
- B. Assess the patient for further signs and symptoms of infection.
- C. Inform the primary care provider that the vascular supply may be compromised.
- D. Liaise with the wound-ostomy-continence (WOC) nurse because the ostomy appliance around the stoma may be too loose.
Correct Answer: C
Rationale: A healthy stoma is pink or red. A change from this normal color to a dark purplish color suggests that the vascular supply may be compromised. A loose ostomy appliance and infections do not cause a dark purplish stoma.
The nurse is assessing a patient admitted with renal stones. During the admission assessment, what parameters would be priorities for the nurse to address? Select all that apply.
- A. Dietary history
- B. Family history of renal stones
- C. Medication history
- D. Surgical history
- E. Vaccination history
Correct Answer: A,B,C
Rationale: Dietary and medication histories and family history of renal stones are obtained to identify factors predisposing the patient to stone formation. When caring for a patient with renal stones it would not normally be a priority to assess the vaccination history or surgical history, since these factors are not usually related to the etiology of kidney stones.
A patient has a flaccid bladder secondary to a spinal cord injury. The nurse recognizes this patients high risk for urinary retention and should implement what intervention in the patients plan of care?
- A. Relaxation techniques
- B. Sodium restriction
- C. Lower abdominal massage
- D. Double voiding
Correct Answer: D
Rationale: To enhance emptying of a flaccid bladder, the patient may be taught to double void. After each voiding, the patient is instructed to remain on the toilet, relax for 1 to 2 minutes, and then attempt to void again in an effort to further empty the bladder. Relaxation does not affect the neurologic etiology of a flaccid bladder. Sodium restriction and massage are similarly ineffective.
The nurse who is leading a wellness workshop has been asked about actions to reduce the risk of bladder cancer. What health promotion action most directly addresses a major risk factor for bladder cancer?
- A. Smoking cessation
- B. Reduction of alcohol intake
- C. Maintenance of a diet high in vitamins and nutrients
- D. Vitamin D supplementation
Correct Answer: A
Rationale: People who smoke develop bladder cancer twice as often as those who do not smoke. High alcohol intake and low vitamin intake are not noted to contribute to bladder cancer.
Resection of a patients bladder tumor has been incomplete and the patient is preparing for the administration of the first ordered instillation of topical chemotherapy. When preparing the patient, the nurse should emphasize the need to do which of the following?
- A. Remain NPO for 12 hours prior to the treatment.
- B. Hold the solution in the bladder for 2 hours before voiding.
- C. Drink the intravesical solution quickly and on an empty stomach.
- D. Avoid acidic foods and beverages until the full cycle of treatment is complete.
Correct Answer: B
Rationale: The patient is allowed to eat and drink before the instillation procedure. Once the bladder is full, the patient must retain the intravesical solution for 2 hours before voiding. The solution is instilled through the meatus; it is not consumed orally. There is no need to avoid acidic foods and beverages during treatment.