The nurse cares for a client six hours post-operative following a transurethral resection of a prostate (TURP).
The client is demonstrating signs and symptoms of ?
urinary catheter obstruction
shock
hyponatremia
urinary tract infection
The Correct Answer is A
Choice A rationale: The signs and symptoms of urinary catheter obstruction include hematuria with clots, bladder spasms, and a feeling of urinary urgency. The nurse should increase the rate of the continuous bladder irrigation to flush out the clots and relieve the obstruction. The nurse should also monitor the client's vital signs, fluid balance, and pain level. The other options are not consistent with the client's presentation.
Choice B rationale: Shock would cause hypotension, tachycardia, and decreased urine output.
Choice C rationale: Hyponatremia would cause confusion, weakness, and seizures.
Choice D rationale: Urinary tract infection would cause fever, chills, and foul-smelling urine.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale: Low blood pressure sensed by baroreceptors in the kidneys would stimulate the renin-angiotensin-aldosterone system, which regulates blood pressure and sodium balance.
Choice B rationale: Low osmolality sensed by osmoreceptors in the kidneys would
indicate that the body has excess water and needs to excrete it, which would inhibit ADH release.
Choice C rationale: ADH, or antidiuretic hormone, is a peptide hormone that regulates the water balance in the body. It is released from the posterior pituitary gland in response to signals from the hypothalamus. When the plasma osmolarity, or the concentration of solutes in the blood, is high, it means that the body is dehydrated and needs to conserve water. The osmoreceptors in the hypothalamus detect this change and stimulate the release of ADH, which acts on the kidneys to increase water
reabsorption and decrease urine output. This helps to lower the plasma osmolarity and restore the water balance.
Choice D rationale: High concentration of potassium sensed by chemoreceptors in the carotid body would affect the acid-base balance and respiratory rate, but not ADH
release.
Correct Answer is B
Explanation
Choice A rationale: Metformin does not significantly affect insulin release from the pancreas or glucagon secretion but reduces glucose production by the liver and enhances insulin sensitivity in tissues.
Choice B rationale: Metformin primarily works by reducing glucose production in the liver and improving the body's response to insulin, thereby lowering blood sugar levels.
Choice C rationale: Metformin does not notably slow carbohydrate absorption in the small intestine.
Choice D rationale: Metformin does not directly increase insulin production from the pancreas.
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