NURSING NUR 3010 Wayne State University Hesi Med Surg 3 2021 FINAL. DOWNLOAD TO GET AN A

1. when preparing a client with ascites for a paracentesis, which instruction should the nurse provide to the client? a. Lie in a supine position for the procedure b. Take rapid and shallow breaths c. Void to empty bladder completely d. Lie on the right side after the procedure o Abdominal paracentesis is a procedure to remove abnormal fluid buildup in your abdomen. Fluid builds up because of liver problems, such as swelling and scarring. Heart failure, kidney disease, a mass, or problems with your pancreas may also cause fluid buildup. o Before procedure, You may be asked to urinate in order to empty your bladder. You are taken to the procedure room and moved to a table or bed. You will need to lie on your back or on your side. 2. an adult male client newly diagnosed with crohn's disease asks the nurse if he can still eat dairy products. how should the nurse a. Suggest eliminating dairy for a while to assess for changes in bowel patterns b. Explain that dairy products are not high in fiber and are not beneficial c. Encourage intake of calcium supplements to replace dairy products d. Recommend a diet high in dairy products to provide adequate dietary protein o Chron’s disease is Inflammation of segments of the bowel o S x S include - abdominal pain, diarrhea, weight loss, anemia, ulcer formation o Interventions: NPO, Administer fluids/electrolytes, parenteral nutrition IV o Diet: Low residue, low fiber. Try elimination diet, so to understand what irritates your bowels. 3. the nurse plans to assess urine in the catheter bag of a client who is receiving bladder irrigation fluid following a transurethral resection of the prostate (TURP). which observation indicates a possible postoperative complications and should be reported to the healthcare provider immediately? a. Bright red urine in the foley bag 12 hours postoperative b. Thick red fluid with clots in foley tubing 12 hours postoperative c. Thick amber-colored fluid in the foley bag 24 hours postoperative d. Light yellow or colorless urine in the foley bag 48 hours postoperative o Transurethral resection of the prostate (TURP) is the surgical removal of part of the prostate gland. It is one option available to relieve the symptoms of an enlarged prostate or other benign (non-cancerous) prostate disease. o Signs of trouble from the catheter would include increasing sensations of bladder fullness and needing to urinate along with a lack of drainage of urine through the catheter into the drainage bag. Excessively bloody urine would also be an indication to call. While this may be a subjective determination, signs of heavy bleeding include the passage of clots through the catheter into the bag and the appearance of ketchup thickness of fluid in the urinary bag. This study source was downloaded by from CourseH on :28:28 GMT -05:00 4. The nurse reviews the laboratory results of a client during an annual physical examination and identifies a positive guaiac test, which additional serum laboratory test result should the nurse review? A. White blood cell count B. Glucose C. Platelet count D. Amylase o The stool guaiac test looks for hidden (occult) blood in a stool sample. It can find blood even if you cannot see it yourself. It is the most common type of fecal occult blood test (FOBT). o Do Not eat these foods before this test : Red meat, Cantaloupe, Uncooked broccoli, Turnip, Radish, Horseradish o This test detects blood in the digestive tract. o Abnormal results may be due to problems that cause bleeding in the stomach or intestinal tract 5. The nurse assess a client with a history of cirrhosis who is admitted with worsening ascites. It is most important for the nurse ________ additional finding? a. Hypotension b. Ecchymosis c. Anorexia d. Pruritus o Hepatic cirrhosis is a chronic hepatic disease characterized by diffuse destruction and fibrotic regeneration of hepatic cells. o Caused by excessive alcohol intake, hepatitis, injury o Cirrhosis causes the liver to slow or stop production of proteins needed for blood clotting. When blood doesn't clot properly, bruising and bleeding can occur spontaneously 6. An adult client who who had a gastric bypass surgery 2 weeks ago is admitted with possible anastomosis the client touch, and their vital signs are: temperature 101 f ( ) heart rate 130 beats/minute, respiratory rate 25 beats/min , blood pressure 100/50 mmHg. Which intervention is most important for the nuse to include in the client plan of car? a. Encourage regular turning b. Monitor skin for breakdown c. Strict iv fluid replacement d. Assess wound drainage daily 7. A picture with a black emesis, what do you check first on the patient? Vital signs, may indicate hemmoraging This study source was downloaded by from CourseH on :28:28 GMT -05:00 Assessments for GI Bleeds o Serial H/H (typically q 4 or q 6 hours) o Monitor PLTs, INR, PTT o Watch for signs of bleeding o Monitor BP and check for orthostatic hypotension o Perform occult blood test on stool o Assess abdominal pain Interventions o Ensure two IVs in place for blood administration, fluids, antibiotics (if needed), electrolyte replacement, protonix gtt, etc… o Make sure pt’s type & screen is current; transfuse as necessary o Prep patient for endoscopy (either EGD or colonoscopy) o Prep patient for interventional radiology if problem can’t be treated by traditional endoscopy o Anticipate patient being NPO initially, then clears, then advance as tolerated o Administer medications such as protonix, antifungals and antibiotics as needed o Replace fluids and electrolytes o Anticipate many many trips to the bedside commode (or many many clean-up projects). Blood in the GI tract is very irritating, which leads to increased gastric motility. 8. Diverticulosis, what kind of diet do you tell the client to follow? With diverticulosis? High fiber With diverticulitis? Acute : npo , recovery:low fiber, maintenance: high fiber 9. A patient has pancreatitis and also rebound tenderness. What do you assess for in the patient next? Appendicitis or peronitis o What it is o Labs o Signs and symptoms 10. Prepare to insert a large-bore IV catheter if a patient has low hemoglobin (8 and below) Because a hemoglobin that low, need to be prepared to do blood traansfusions. 11. What do you teach a patient going home and has esophageal varices? a. Limit alcohol b. Eat healthy foods