A 63-year-old male patient had a cystectomy with an ileal conduit ...

[melina_rosy]

A 63-year-old male patient had a cystectomy with an ileal conduit yesterday. Which new assessment data is most important for the nurse to communicate to the physician?
 
  a. Cloudy appearing urine
  b. Hypotonic bowel sounds
  c. Heart rate 102 beats/minute
  d. Continuous stoma drainage

Question 2

A 58-year-old male patient who weighs 242 lb (110 kg) undergoes a nephrectomy for massive kidney trauma due to a motor vehicle crash. Which postoperative assessment finding is most important to communicate to the surgeon?
 
  a. Blood pressure is 102/58.
  b. Urine output is 20 mL/hr for 2 hours.
  c. Incisional pain level is reported as 9/10.
  d. Crackles are heard at bilateral lung bases.

[chinwesucks]

Answer to Question 1

ANS: C
Tachycardia may indicate infection, hemorrhage, or hypovolemia, which are all serious complications of this surgery. The urine from an ileal conduit normally contains mucus and is cloudy. Hypotonic bowel sounds are expected after bowel surgery. Continuous drainage of urine from the stoma is normal.

Answer to Question 2

ANS: B
Because the urine output should be at least 0.5 mL/kg/hr, a 40 mL output for 2 hours indicates that the patient may have decreased renal perfusion because of bleeding, inadequate fluid intake, or obstruction at the suture site. The blood pressure requires ongoing monitoring but does not indicate inadequate perfusion at this time. The patient should cough and deep breathe, but the crackles do not indicate a need for an immediate change in therapy. The incisional pain should be addressed, but this is not as potentially life threatening as decreased renal perfusion. In addition, the nurse can medicate the patient for pain.

[melina_rosy]

TYSM

[alvinum]

Gracias!