The nurse is caring for a client after receiving extracorporeal shock wave lithotripsy (ESWL). Which of the following actions should the nurse take?

Monitor the client for signs of hemorrhage.

Monitor the incision site for signs of infection.

Monitor the client's urine for sand or gravel.

Monitor the percutaneous nephrostomy tube for signs of obstruction.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Hemorrhage is not a typical complication of extracorporeal shock wave lithotripsy (ESWL), as it is a non-invasive procedure targeting kidney stones using shock waves. The risk of significant bleeding is minimal, and monitoring focuses more on urinary changes or localized pain rather than hemorrhage.

Choice B rationale

ESWL does not involve surgical incisions, so there is no incision site to monitor for infection. This action is irrelevant to the procedure's mechanism, which uses external shock waves to fragment stones rather than invasive surgical methods.

Choice C rationale

Sand or gravel in the urine is a common finding after ESWL as the procedure fragments kidney stones into smaller particles. These fragments are excreted through the urinary system. Monitoring urine for these particles helps evaluate the procedure's effectiveness and ensure stones are adequately eliminated.

Choice D rationale

Percutaneous nephrostomy tubes are used for urinary drainage but are not a standard component of ESWL. Monitoring for tube obstruction applies to invasive procedures, whereas ESWL focuses on non-invasive stone fragmentation. This action is unrelated to the client's current treatment modality. .

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Correct Answer is B

Explanation

Choice A rationale

Reducing caffeine consumption decreases bladder irritation and helps manage urinary incontinence symptoms. Caffeine stimulates bladder activity and exacerbates urgency and frequency. Clinical evidence supports its reduction as part of an effective urinary incontinence management strategy.

Choice B rationale

Grapefruit juice is acidic and irritates the bladder lining, worsening symptoms of urinary incontinence. Substituting orange juice with grapefruit juice does not mitigate bladder irritation. Both contain acids and should be avoided to manage urinary incontinence effectively. Citrus juices are contraindicated in clients managing urinary incontinence.

Choice C rationale

Kegel exercises improve pelvic floor muscle strength, reducing urinary incontinence episodes. They enhance the function of the urinary sphincter and support better bladder control. Kegel exercises are widely recommended in clinical practice for patients managing urinary incontinence and are supported by robust scientific evidence.

Choice D rationale

Scheduled bathroom visits prevent bladder overdistension and manage urinary incontinence symptoms effectively. Timed voiding trains the bladder to hold urine for specific periods, reducing the frequency of urgency episodes. It is an effective behavioral approach supported by clinical guidelines for managing urinary incontinence.

A. Corticosteroid. B. Diphenhydramine. C. Desmopressin (DDAVP). D. Hydrochlorothiazide (HCTZ).

Correct Answer is A

Explanation

Choice A rationale

Corticosteroids are used in thrombocytopenia because they suppress the immune response, particularly in immune thrombocytopenic purpura (ITP). They reduce platelet destruction by inhibiting autoantibody formation and increasing platelet lifespan. Normal platelet count ranges from 150,000 to 400,000/µL. Thrombocytopenia occurs when platelets drop below 150,000/µL, increasing bleeding risk. Corticosteroids can also decrease capillary permeability, minimizing petechiae and ecchymoses.

Choice B rationale

Diphenhydramine, an antihistamine, is used for allergic reactions but has no role in treating thrombocytopenia. It does not address the underlying immune or hematologic causes of low platelet counts. Its primary actions include H1 receptor antagonism, reducing histamine-mediated symptoms like itching and swelling. However, it lacks immunosuppressive or hematologic-stimulating effects essential for managing thrombocytopenia.

Choice C rationale

Desmopressin (DDAVP) is a synthetic antidiuretic hormone analog used for certain bleeding disorders like von Willebrand disease or mild hemophilia A. It increases factor VIII and von Willebrand factor levels, improving clotting. However, it is not indicated for thrombocytopenia as it does not address platelet count deficiencies or immune-mediated platelet destruction.

Choice D rationale

Hydrochlorothiazide (HCTZ) is a thiazide diuretic used for hypertension and edema. Its mechanism of action involves inhibiting sodium reabsorption in the distal tubule, promoting diuresis. HCTZ has no effect on platelet counts or immune mechanisms and is not used in thrombocytopenia. Its side effects, like electrolyte imbalances, may complicate patient management.

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The nurse is caring for a client after receiving extracorporeal shock wave lithotripsy (ESWL). Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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