Which of the following post-surgical clients warrant an immediate follow up by the nurse? (Select all that apply.)

Patient with lung surgery has 20 ml/hr of urine output via catheter.

Patient with appendix surgery has thready pulse and blood pressure is 90/60.

Patient with knee surgery has approximated incision.

Patient with femoral artery surgery has strong pedal pulse.

Patient with bladder surgery has bloody urine within the first 12 hours.

Answer and Explanation

Correct Answer : A,B,E

A.   A urine output of 20 ml/hr is considered inadequate and may indicate decreased kidney perfusion or function. This client likely needs immediate assessment and intervention to address potential renal complications.
B.   A patient with appendix surgery exhibiting a thready pulse and a blood pressure of 90/60 should be followed up immediately, as these signs can indicate shock, which is a medical emergency.
C.   An approximated incision indicates that the wound edges are well-aligned and healing is progressing as expected. This does not typically warrant immediate follow-up unless there are signs of infection or other complications.
D.   A strong pedal pulse suggests adequate blood flow distal to the surgical site. This is a positive finding and does not typically require immediate follow-up unless there are signs of vascular compromise or other complications.
E.   A patient with bladder surgery having bloody urine within the first 12 hours can be expected, but if the bleeding is heavy or increases, it would warrant immediate follow-up.

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Correct Answer is B

Explanation

A. Canola oil is a healthier option compared to oils high in saturated fats, such as butter or lard. It does not significantly contribute to dietary cholesterol intake. Therefore, this statement does not indicate a need for follow-up teaching on a low-cholesterol diet.
B. Eggs are high in dietary cholesterol, and consuming two eggs daily can significantly increase cholesterol intake. For someone with elevated cholesterol levels or a history of atherosclerosis, this dietary habit may contribute to further elevation of cholesterol levels and potentially worsen cardiovascular health. Hence, this statement indicates the need for follow-up teaching on reducing dietary cholesterol intake.
C. Lemon juice is a low-calorie and low-cholesterol flavoring option. It does not significantly impact cholesterol intake. Therefore, this statement does not indicate a need for follow-up teaching on a low- cholesterol diet.
D. Omega-3 fatty acids are beneficial for heart health and do not contribute to dietary cholesterol intake. In fact, they may help reduce triglyceride levels and inflammation. Therefore, this statement does not indicate a need for follow-up teaching on a low-cholesterol diet.

A. Potassium: 2.9 mEq/L (2.9 mm) B. Creatinine: 1.2 mg/dL (106.1 umol/L) C. Hemoglobin: 14.8 mg/dL (148 mmol/L) D. Sodium: 134 mEq/L (134 mmol/L)

Correct Answer is A

Explanation

A. A potassium level of 2.9 mEq/L is below the normal range (typically 3.5-5.0 mEq/L). Abnormal potassium levels can affect cardiac function, leading to arrhythmias (irregular heartbeats), especially if the potassium level drops further or if there is rapid fluctuation. This is a critical finding that requires immediate attention from the surgical team to assess the client's cardiac status and determine if potassium replacement is needed before proceeding with surgery.
B. Creatinine levels are used to assess kidney function. A creatinine level of 1.2 mg/dL is within the normal range (typically 0.6-1.2 mg/dL). While kidney function is important to evaluate before surgery, this result is not immediately concerning enough to require an urgent call to the surgical team.
C. Hemoglobin levels are assessed to evaluate oxygen-carrying capacity of the blood. A hemoglobin level of 14.8 g/dL is within the normal range (typically 12-16 g/dL for women and 13-18 g/dL for men). This result indicates adequate oxygen-carrying capacity and does not require immediate communication with the surgical team.

D. Sodium levels are important for fluid balance and nerve function. A sodium level of 134 mEq/L is within the normal range (typically 135-145 mEq/L). While sodium levels should be monitored, this result is not critically abnormal and does not necessitate an urgent call to the surgical team.

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Which of the following post-surgical clients warrant an immediate follow up by the nurse? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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