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. Peanut butter sandwich with soda and cookies is not a high-protein choice and contains excessive sugar and empty calories.
B. Salad with lettuce and fruit may not provide sufficient protein for wound healing.

C. A tuna fish sandwich is high in protein, which aligns with the goal of promoting wound healing.
D. Vegetable soup, crackers, and milk lack adequate protein content compared to a tuna fish sandwich.

A. Verify troponin level assessments are scheduled every 3 to 6 hours for a series of three. B. Place an indwelling urinary catheter and institute strict intake and output measurements. C. Count and record the number of premature ventricular contractions per minute. D. Record pain score and administer sublingual nitroglycerine every 5 minutes up to 3 doses.

Correct Answer is D

Explanation

A. While monitoring troponin levels is important for diagnosing myocardial infarction, immediate relief of chest pressure and shortness of breath is a higher priority.
B. Placing an indwelling urinary catheter and measuring intake and output is not the immediate priority for managing acute chest pain and potential myocardial ischemia.
C. Counting premature ventricular contractions is useful but not the most immediate action in managing acute chest pressure and shortness of breath.
D. Recording the pain score and administering sublingual nitroglycerine addresses the acute symptoms of chest pressure and shortness of breath, aiming to relieve myocardial ischemia.

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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

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