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 C
Explanation
A. Hypoactive deep tendon reflexes is incorrect. Hypocalcemia often leads to hyperactive reflexes, not hypoactive reflexes. This is because calcium plays a role in muscle and nerve function, and a deficiency can cause heightened neuromuscular irritability.
B. Constipation is incorrect. Constipation is more commonly associated with hypercalcemia (elevated calcium levels), not hypocalcemia. Low calcium levels tend to cause muscle spasms and neuromuscular symptoms rather than gastrointestinal issues.
C. Tingling of the extremities is correct. Tingling or paresthesia of the extremities is a common symptom of hypocalcemia. It occurs due to increased nerve excitability caused by low calcium levels, which can lead to muscle cramps, tetany, and numbness.
D. Shortened QT intervals is incorrect. A shortened QT interval is typically associated with hypercalcemia (high calcium levels), not hypocalcemia. Hypocalcemia is more likely to cause a prolonged QT interval on the ECG.
Correct Answer is ["A","B","C","D"]
Explanation
A. Perioperative antibiotics is correct. The benchmark is 100%. Performance was 90.4% in Q1, 88.2% in Q2, and 92.6% in Q3, all of which are below the benchmark, indicating noncompliance.
B. Smoking cessation is correct. The benchmark is 75%. While Q2 reached 100%, Q1 (70.6%) and Q3 (74%) were both below the benchmark, showing inconsistent compliance.
C. Glucose control is correct. The benchmark is 90%. All quarters were below the benchmark: Q1 (75.2%), Q2 (85.5%), and Q3 (82%).
D. Post operative normothermia is correct. The benchmark is 85%. Q1 (69%) fell below the benchmark, although Q2 and Q3 met or exceeded it. Still, any quarter below the benchmark signals an area for improvement.
E. Intraoperative vancomycin is incorrect. The benchmark is 80.2%. While Q1 (75.7%) fell slightly below the benchmark, Q2 (80.5%) and Q3 (92%) met or exceeded it, indicating overall adequate performance and improvement over time.
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