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The nurse should first fully assess the client for signs of volume depletion and shock, and then notify the provider. The radical nature of the surgery and the proximity of the surgery to the adrenal gland put the client at risk for hemorrhage and adrenal insufficiency. Hypertension is a clinical manifestation associated with both hemorrhage and adrenal insufficiency. Hypertension is particularly dangerous for the remaining kidney, which must receive adequate perfusion to function effectively. Which action should the nurse take first?
- A. Reposition the client to promote comfort.
- B. Measure the specific gravity of the client's urine.
- C. Administer intravenous pain medications.
- D. Assess the rate and quality of the client's pulse.
Correct Answer: D
Rationale: Assessing the rate and quality of the client's pulse is critical to evaluate for signs of volume depletion or shock, which are potential complications post-nephrectomy due to hemorrhage or adrenal insufficiency. This assessment provides essential data before notifying the provider. Repositioning, measuring urine specific gravity, or administering pain medication do not address the immediate risk of these complications.
You may also like to solve these questions
A nurse teaches a client with polycystic kidney disease (PKD). Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)
- A. Take your blood pressure every morning.
- B. Weigh yourself at the same time each day.
- C. Adjust your diet to prevent diarrhea.
- D. Contact your provider if you have visual disturbances.
- E. Assess your urine for renal stones.
Correct Answer: A,B,D
Rationale: Clients with PKD should monitor blood pressure and weight daily to track hypertension and fluid status, and report visual disturbances, which may indicate a berry aneurysm. Adjusting diet to prevent constipation, not diarrhea, is appropriate, and renal stones are not a primary concern in PKD.
A nurse reviews laboratory results for a client with glomerulonephritis. The client's glomerular filtration rate (GFR) is 40 ml/min as measured by a 24-hour creatinine clearance. How should the nurse interpret this finding? (Select all that apply.)
- A. Excessive GFR
- B. Normal GFR
- C. Reduced GFR
- D. Potential for fluid overload
- E. Potential for dehydration
Correct Answer: C,D
Rationale: A GFR of 40 ml/min is significantly reduced compared to the normal range of 100-120 ml/min, indicating impaired kidney function. This reduction increases the risk of fluid overload, leading to hypertension and pulmonary edema, rather than dehydration.
A nurse cares for a middle-aged female client with diabetes mellitus who is being treated for the third episode of acute pyelonephritis in the past year. The client asks, 'What can I do to help prevent these infections?' How should the nurse respond?
- A. Test your urine daily for the presence of ketone bodies and proteins.
- B. Use tampons rather than sanitary napkins during your menstrual period.
- C. Drink more water and empty your bladder more frequently during the day.
- D. Keep your hemoglobin A1C under 9% by keeping your blood sugar controlled.
Correct Answer: C
Rationale: Increasing fluid intake (especially water) and frequent voiding help flush bacteria from the urinary tract, reducing the risk of pyelonephritis. Chronically elevated blood glucose in diabetes can promote bacterial growth, but frequent voiding is the most direct preventive measure. Testing urine for ketones/proteins, using tampons, or controlling hemoglobin A1C are not as directly related to preventing urinary tract infections.
A nurse assesses a client with nephrotic syndrome. For which clinical manifestations should the nurse assess? (Select all that apply.)
- A. Proteinuria
- B. Hypoalbuminemia
- C. Dehydration
- D. Lipiduria
- E. Dysuria
- F. Costovertebral angle (CVA) tenderness
Correct Answer: A,B,D
Rationale: Nephrotic syndrome is characterized by proteinuria (>3.5 g/24 hr), hypoalbuminemia, and lipiduria due to glomerular damage. Dehydration is unlikely due to fluid overload, and dysuria and CVA tenderness are associated with infections like cystitis or pyelonephritis, not nephrotic syndrome.
A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma. Which statement should the nurse include in this client's teaching?
- A. Since you only have one kidney, a salt and fluid restriction is required.
- B. Your therapy will include hemodialysis while you recover.
- C. Medications will be prescribed to control your high blood pressure.
- D. You need to avoid participating in contact sports like football.
Correct Answer: D
Rationale: Clients with one kidney should avoid contact sports to prevent injury to the remaining kidney. Salt and fluid restriction, dialysis, or new hypertension medications are not typically required post-nephrectomy unless other complications arise.