A patient with a history of polycystic kidney disease is admitted to the surgical unit after having shoulder surgery. Which of the routine postoperative orders is most important for the nurse to discuss with the health care provider?
Draw blood urea nitrogen (BUN) and creatinine in 2 hours.
Give ketorolac 10 mg PO PRN for pain
Infuse 5% dextrose in normal saline at 75 mL/hr.
Order regular diet after patient is awake and alert
The Correct Answer is B
A. Draw blood urea nitrogen (BUN) and creatinine in 2 hours: Monitoring BUN and creatinine is important in patients with polycystic kidney disease, but drawing labs immediately postoperatively is generally not urgent unless there are signs of acute kidney injury.
B. Give ketorolac 10 mg PO PRN for pain: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can reduce kidney perfusion and worsen renal function, particularly in patients with preexisting kidney disease such as polycystic kidney disease. Discussing this order with the healthcare provider is essential to prevent potential nephrotoxicity.
C. Infuse 5% dextrose in normal saline at 75 mL/hr: Administering IV fluids is common postoperatively to maintain hydration. This order is generally safe and supports perfusion unless the patient has fluid restrictions or heart failure.
D. Order regular diet after patient is awake and alert: Advancing the diet once the patient is awake and alert is routine and generally safe. It does not pose an immediate risk to kidney function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Diuretic use: Some diuretics, particularly thiazides, are actually prescribed to prevent calcium stone formation by reducing urinary calcium excretion. Diuretic use is not considered a primary risk factor for urolithiasis.
B. BMI less than 25: A lower BMI is not linked with kidney stone formation. In fact, higher BMI and obesity are more commonly associated with an increased risk due to metabolic changes that affect urine composition.
C. Family history: A positive family history significantly increases the risk of developing urolithiasis. Genetic predisposition and shared environmental factors contribute to stone formation, making this a strong and well-established risk factor.
D. Hypocalcemia: Urolithiasis is often associated with hypercalcemia or hypercalciuria, which increase the concentration of calcium in urine and promote stone development. Hypocalcemia does not contribute to stone formation and is not a risk factor.
Correct Answer is B
Explanation
A. Decreased pH: A lower urine pH can result from diet, such as high-protein intake, or metabolic conditions like acidosis. While it is important to note, a mildly acidic urine pH is not usually urgent and does not require immediate notification of the healthcare provider.
B. Increased protein: Proteinuria is a significant finding because it indicates possible glomerular damage or kidney disease. Persistent protein loss in the urine can contribute to nephrotic syndrome, fluid imbalance, and long-term renal impairment, making it a priority to report promptly.
C. Increased WBC: An elevated white blood cell count in urine suggests infection, such as a urinary tract infection. While important, this requires follow-up with a urine culture and treatment but is not as urgent as proteinuria, which may indicate progressive renal damage.
D. Increased specific gravity: A higher specific gravity usually reflects concentrated urine from dehydration or reduced fluid intake. This finding is generally reversible with hydration and does not necessarily indicate a pathologic renal condition requiring immediate provider notification.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.