When a patient with splenomegaly is scheduled for splenectomy, ...

[Jkov05]

When a patient with splenomegaly is scheduled for splenectomy, which action will the nurse include in the preoperative plan of care?
 
  a. Discourage deep breathing to reduce risk for splenic rupture.
  b. Teach the patient to use ibuprofen (Advil) for left upper quadrant pain.
  c. Schedule immunization with the pneumococcal vaccine (Pneumovax).
  d. Avoid the use of acetaminophen (Tylenol) for 2 weeks prior to surgery.

Question 2

Which information obtained by the nurse assessing a patient admitted with multiple myeloma is most important to report to the health care provider?
 
  a. Serum calcium level is 15 mg/dL.
  b. Patient reports no stool for 5 days.
  c. Urine sample has Bence-Jones protein.
  d. Patient is complaining of severe back pain.

[kaylee05]

Answer to Question 1

ANS: C
Asplenic patients are at high risk for infection with Pneumococcus and immunization reduces this risk. There is no need to avoid acetaminophen use before surgery, but nonsteroidal antiinflammatory drugs (NSAIDs) may increase bleeding risk and should be avoided. The enlarged spleen may decrease respiratory depth and the patient should be encouraged to take deep breaths.

Answer to Question 2

ANS: A
Hypercalcemia may lead to complications such as dysrhythmias or seizures, and should be addressed quickly. The other patient findings will also be discussed with the health care provider, but are not life threatening.

[Jkov05]

Excellent

[ebonylittles]

TYSM