A client is recovering from an adrenalectomy for pheochromocytoma removal. Which postoperative assessment should be prioritized to ensure early detection of complications?
Monitor blood pressure closely for fluctuations.
Check the client's urine output every hour.
Evaluate client's pain level using a numeric scale.
Assess the surgical site for signs of infection.
The Correct Answer is A
A. Monitor blood pressure closely for fluctuations is correct. After an adrenalectomy for pheochromocytoma, it is critical to closely monitor the client's blood pressure. Pheochromocytomas are tumors of the adrenal glands that cause excessive production of catecholamines (like epinephrine and norepinephrine), leading to severe hypertension. Postoperatively, the sudden removal of the tumor may cause blood pressure fluctuations, including hypotension after the excess catecholamines are no longer being produced. Monitoring blood pressure is key to detecting complications like hypotension or hypertensive crises early.
B. Check the client's urine output every hour is incorrect. While urine output is important to monitor in general postoperative care, it is not the priority in this case. The more immediate concern following adrenalectomy for pheochromocytoma is blood pressure control and hemodynamic stability, not just urine output.
C. Evaluate the client's pain level using a numeric scale is incorrect. While managing pain is essential, the priority assessment postoperatively for this particular procedure is to monitor for hemodynamic changes, particularly due to the risk of fluctuating blood pressure. Pain can be managed after addressing the primary concerns.
D. Assess the surgical site for signs of infection is incorrect. While infection is a concern for any postoperative patient, the most immediate risk after adrenalectomy for pheochromocytoma is hemodynamic instability due to catecholamine imbalance. Monitoring blood pressure takes precedence over checking for infection in the early postoperative period.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Has an increasing life expectancy is incorrect. In recent years, the U.S. has seen a stagnation or even decline in life expectancy, partly due to chronic disease prevalence, the opioid crisis, and disparities in care.
B. Provides less acute myocardial infarction care is incorrect. The U.S. generally provides high-quality acute care, including treatment for heart attacks, and often performs well in this area compared to other countries.
C. Has lower maternal and neonatal mortality rates is incorrect. The U.S. actually has higher maternal and infant mortality rates compared to other high-income nations, often due to systemic disparities and fragmented care.
D. Spends more per capita on health care is correct. The U.S. consistently spends the most per person on healthcare among high-income countries, yet often does not achieve better overall outcomes, highlighting inefficiencies in the system.
Correct Answer is ["D","E","H"]
Explanation
A. Encouraging the use of calcium supplements is incorrect. Clients with hyperparathyroidism often have elevated calcium levels, so increasing calcium intake can worsen hypercalcemia and increase the risk of kidney stones.
B. Encouraging the consumption of oxalate-rich foods is incorrect. Oxalate-rich foods, such as spinach, beets, and nuts, can increase the risk of calcium oxalate stones, especially in individuals with hyperparathyroidism. Therefore, oxalate-rich foods should be avoided.
C. Encouraging a low-calcium diet is incorrect. Although high calcium intake can worsen hypercalcemia, a low-calcium diet is not typically recommended. Instead, the focus should be on maintaining balanced calcium levels, as calcium is still important for overall health.
D. Administer oral phosphates as ordered is correct. Phosphates can help lower calcium levels in the blood by binding to calcium and reducing its absorption, which can help prevent kidney stone formation.
E. Increase fluids and fiber is correct. Increased fluid intake helps dilute urine, reducing the risk of stone formation. Additionally, fiber can promote overall digestive health, which can be helpful for preventing kidney stones.
F. Administer furosemide as ordered is incorrect. Furosemide, a diuretic, increases urine output but does not prevent kidney stones. It may actually increase the risk by causing dehydration, which promotes stone formation.
G. Administer calcium chelators is incorrect. Calcium chelators are not typically used in the prevention of kidney stones caused by hyperparathyroidism, and their use could interfere with necessary calcium levels in the body.
H. Encouraging increased fluid intake is correct. Adequate fluid intake is essential in preventing kidney stones, as it helps dilute urine and reduces the concentration of calcium and other stone-forming substances.
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