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 ["A","B","C","D"]

Explanation

Choice A rationale

Restricting sodium intake is essential as high sodium levels can increase fluid retention, leading to elevated blood pressure. A low-sodium diet reduces the workload on blood vessels and decreases the risk of cardiovascular complications associated with hypertension. The recommended sodium intake for adults should be less than 2,300 mg per day, and ideally closer to 1,500 mg daily for optimal blood pressure control.

Choice B rationale

Hypertension can lead to damage to the small blood vessels in the retina, resulting in hypertensive retinopathy. Stressing ophthalmic care ensures early detection and management of vision changes that may be indicative of ongoing vascular damage. Regular ophthalmologic evaluation aids in preventing irreversible vision loss and allows better management of systemic hypertension's effects on ocular health.

Choice C rationale

Increasing the intake of fruits and vegetables provides essential nutrients such as potassium, magnesium, and dietary fiber. Potassium helps counteract the effects of sodium and relaxes blood vessel walls, lowering blood pressure. The DASH diet, rich in fruits and vegetables, is widely recommended for individuals with hypertension to promote cardiovascular health and regulate blood pressure.

Choice D rationale

Taking prescribed medications as ordered ensures consistent management of blood pressure and prevention of complications such as stroke, heart attack, and kidney damage. Antihypertensive medications, including ACE inhibitors, beta-blockers, or diuretics, work through various mechanisms to lower blood pressure. Adherence prevents fluctuations and maintains target levels of less than 140/90 mmHg.

Choice E rationale

Not taking medication when blood pressure is less than 140/90 mmHg is incorrect because hypertension management requires consistent medication to maintain target levels and prevent rebound hypertension. Abrupt discontinuation can lead to complications such as severe hypertensive episodes and organ damage. Regular monitoring is crucial to guide therapy adjustments safely.

A. Medications. B. Negative-pressure devices. C. Penile injections. D. Penis transplant.

Correct Answer is A

Explanation

Choice A rationale

Medications, such as phosphodiesterase type-5 inhibitors (e.g., sildenafil), are typically the next line of treatment for erectile dysfunction (ED) after lifestyle modifications fail. These agents enhance blood flow to the penile tissues during sexual stimulation by inhibiting the breakdown of cyclic guanosine monophosphate, facilitating erectile function.

Choice B rationale

Negative-pressure devices, also known as vacuum erection devices, are considered third-line treatments and are typically used in clients for whom oral medications are contraindicated or have failed. These devices work by mechanically increasing blood flow to the penis but are less effective than pharmacological interventions.

Choice C rationale

Penile injections, such as alprostadil, are invasive and used as a later option when oral medications and devices are unsuccessful or contraindicated. These injections directly relax the smooth muscle to increase penile blood flow, but they are generally not first-line treatments.

Choice D rationale

Penis transplants are experimental and not recognized as a standard treatment for erectile dysfunction. This option is far from practical or feasible and is considered unsuitable for most clients, especially given the complexity of the condition.

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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?

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