The nurse is preparing a client for discharge who underwent a percutaneous nephrolithotomy with nephrostomy tube placement. Which instruction should the nurse include in the client's postoperative discharge teaching?

Report when hematuria becomes pink tinged.

Restrict all physical activities.

Use the incentive spirometer.

Monitor urinary stream for decreased output.

Answer and Explanation

The Correct Answer is D

A.   Pink-tinged hematuria is expected after the procedure, but reporting should be directed at increased bleeding or other signs of complications.
B.   While some activity restrictions are necessary, a complete restriction of all physical activities is generally not advised and can lead to other complications like blood clots or decreased mobility.
C.   An incentive spirometer is typically used to prevent respiratory complications post-surgery, but it is not specifically related to nephrolithotomy procedures.
D.   Monitoring the urinary output is crucial because decreased output can indicate a blockage or other complications related to the nephrostomy tube.

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Correct Answer is C

Explanation

A. Serum electrolytes are important to monitor in chronic kidney disease but do not directly relate to the effects of epoetin alfa.

B. Platelet count is not typically affected by epoetin alfa and does not directly address the client’s symptoms of tiredness.
C. Complete blood count (CBC) is crucial to monitor, especially hemoglobin and hematocrit levels, as epoetin alfa is used to treat anemia in chronic kidney disease, which can cause fatigue.
D. Liver enzymes are not directly related to the effects of epoetin alfa and the symptoms described.

A. Chew food slowly and thoroughly before attempting to swallow. B. Sip fluids slowly with each meal and between meals. C. Eliminate or reduce intake of fatty and gas forming foods. D. Plan volume-controlled, evenly-spaced meals throughout the day.

Correct Answer is D

Explanation

A. While chewing food well is important to aid digestion and prevent discomfort, meal timing and portion control are the primary concerns in gastric bypass patients.

B. Sipping fluids slowly is important, but fluids should generally be taken between meals rather than with meals to prevent stretching the stomach pouch and to avoid dumping syndrome.
C. Reducing fatty and gas-forming foods can help avoid discomfort, but this is less critical than ensuring proper food breakdown through thorough chewing.
D. After gastric bypass surgery, small, frequent meals help prevent dumping syndrome, a condition in which food moves too quickly from the stomach to the small intestine, causing nausea, dizziness, and diarrhea. Portion control is essential to avoid overstretching the reduced stomach pouch and ensure adequate nutrient absorption.

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The nurse is preparing a client for discharge who underwent a percutaneous nephrolithotomy with nephrostomy tube placement. Which instruction should the nurse include in the client's postoperative discharge teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic kidney disease reports to the nurse of feeling increasingly tired. The client receives injections for epoetin alfa three times a week. Which laboratory value should the nurse review?

Correct Answer is C

Explanation

A client who underwent an uncomplicated gastric bypass surgery is having difficulty with diet management. Which dietary instruction is most important for the nurse to explain to the client?

Correct Answer is D

Explanation

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