Which assessment finding is most important to report to the health care provider regarding a patient who has had left-sided extracorporeal shock wave lithotripsy?
Hematuria
Oliguria
Ecchymosis in left flank
left flank discomfort
The Correct Answer is B
A. Hematuria: The presence of blood in the urine is expected for the first few days after extracorporeal shock wave lithotripsy. It results from trauma to the urinary tract and usually resolves on its own, so it does not require urgent reporting unless it becomes severe or prolonged.
B. Oliguria: Decreased urine output is the most concerning finding because it may indicate obstruction from stone fragments or acute kidney injury. This complication can quickly compromise renal function and requires immediate evaluation by the healthcare provider.
C. Ecchymosis in left flank: Bruising around the flank is a common side effect of the shock waves used during lithotripsy. While it may be uncomfortable, it is not considered dangerous and does not require urgent intervention.
D. Left flank discomfort: Pain is expected after the procedure due to both the passage of stone fragments and localized tissue trauma. Analgesics are typically used to manage this symptom, and it is not considered a critical finding to report.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["1370"]
Explanation
Calculation:
- Identify all sources of fluid output.
Voided urine at 1100: 400 mL
Voided urine at 1430: 350 mL
Closed chest drainage system: 175 mL (current) - 155 mL (previous) = 20 mL
NG tube drainage: 575 mL
Jackson-Pratt drainage tube: 25 mL
- Add all the volumes together to find the total output.
Total output = 400 mL + 350 mL + 20 mL + 575 mL + 25 mL
= 1370 mL.
Correct Answer is A
Explanation
A. RBC: Chronic glomerulonephritis often leads to anemia because the damaged kidneys produce less erythropoietin, a hormone necessary for red blood cell production. A decrease in RBC count is therefore an expected finding in this condition.
B. Potassium: Potassium levels usually increase rather than decrease in chronic glomerulonephritis because of reduced kidney function and impaired excretion. Hyperkalemia is a common complication that requires close monitoring.
C. Phosphate: Phosphate levels tend to rise in chronic kidney disease since the kidneys cannot excrete phosphate efficiently. This leads to hyperphosphatemia, which contributes to bone mineral imbalances, not a decrease.
D. Creatinine: Creatinine levels increase in chronic glomerulonephritis because of impaired filtration and reduced clearance. Elevated serum creatinine is one of the key indicators of declining kidney function.
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