Author Question: A nurse assesses a client who is recovering from extracorporeal shock wave lithotripsy for renal ... (Read 111 times)

hbsimmons88 · **on:** Jun 25, 2018

A nurse assesses a client who is recovering from extracorporeal shock wave lithotripsy for renal calculi. The nurse notes an ecchymotic area on the client's right lower back. Which action should the nurse take?

a. Administer fresh-frozen plasma.
b. Apply an ice pack to the site.
c. Place the client in the prone position.
d. Obtain serum coagulation test results.

Question 2

A nurse cares for a client admitted from a nursing home after several recent falls. What prescription should the nurse complete first?

a. Obtain urine sample for culture and sensitivity.
b. Administer intravenous antibiotics.
c. Encourage protein intake and additional fluids.
d. Consult physical therapy for gait training.

fraziera112 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
The shock waves from lithotripsy can cause bleeding into the tissues through which the waves pass. Application of ice can reduce the extent and discomfort of the bruising. Although coagulation test results and fresh-frozen plasma are used to assess and treat bleeding disorders, ecchymosis after this procedure is not unusual and does not warrant a higher level of intervention. Changing the client's position will not decrease bleeding.

Answer to Question 2

ANS: A
Although all interventions are or might be important, obtaining a urine sample for urinalysis takes priority. Often urinary tract infection (UTI) symptoms in older adults are atypical, and a UTI may present with new onset of confusion or falling. The urine sample should be obtained before starting antibiotics. Dietary requirements and gait training should be implemented after obtaining the urine sample.