What staff member should the nurse on the postoperative unit ...

[tnt_battle]

What staff member should the nurse on the postoperative unit assign to do a follow-up assessment for a patient who has returned home after having an intravenous pyelogram 24 hours ago?
 
  1. RN floating from the immunology unit
  2. LPN floating from the nephrology unit
  3. LPN floating from the pulmonology unit
  4. RN floating from the orthopedic unit

Question 2

The nurse is reviewing laboratory data for a patient scheduled for an intravenous pyelogram. Which result should the nurse report to the primary healthcare provider immediately?
 
  1. serum osmolality of 1500 mOsm/kg/H2O
  2. serum creatinine of 1.30 mg/dL
  3. blood urea nitrogen of 20 mg/dL
  4. hourly urine output of 45 mL/hour

[amcvicar]

Answer to Question 1

Correct Answer: 1
Delayed reactions to contrast dyes containing iodine can occur. The most appropriate staff member to follow up with the patient is the RN from the immunology unit. This RN will have extensive experience with hypersensitivity reactions and is best prepared to meet the needs of the patient. Prior to discharge the nurse should instruct the patient to contact the healthcare provider for any delayed reactions to the dye (breathing difficulty, rash, itching, rapid heartbeat). The other staff may not have the necessary experience to follow-up with the patient.

Answer to Question 2

Correct Answer: 1
Prior to the IVP the nurse should assess renal and fluid status, including serum osmolality, creatinine, and blood urea nitrogen (BUN) levels. Notify the physician of any abnormal values. This patient's serum osmolality is elevated. Normal findings are 501200 mOsm/kg/H2O. Elevated serum osmolality may indicate a high-protein diet, SIADH, Addison disease, dehydration, or hyperglycemia. The creatinine, BUN, and hourly urine output findings are within normal limits for this patient.