ATI Capstone Med-surg Review (2023/2024)
1. A nurse is caring for a client following a bone marrow biopsy. What information should the nurse include in
... [Show More] the discharge education?
The nurse should tell the patient that following the procedure the patient will not be able to drive or operate heavy machinery for the remainder of the day. The patient should have a person with them that can drive them home from their procedure for safety reasons. The patient should also be instructed to monitor for signs of infection, and to notify the physician if these occur. The patient should also be instructed to avoid lifting anything that’s heavier than a gallon of milk for the next 24-48 hours. The patient should also be told that if he/she begins to have bleeding at the surgical site, the patient should lie on the side that the biopsy was performed on for a minimum of 30 minutes. If the bleeding continues after this, the patient should then contact the physician, or be taken to the emergency department immediately.
2. What dietary education should the nurse provide to a client diagnosed with a hiatal hernia?
A patient with a hiatal hernia should be instructed to remain sitting up for a minimum of an hour after eating. The nurse should also advise the patient to avoid any foods that may have a high acid content. Food that would be appropriate for this client includes: bananas, beans, grains, crackers, pasta, rice, and bread. The nurse should also instruct the patient with a hiatal hernia to avoid drinking too much while eating, and consuming small, more frequent meals to avoid dumping syndrome.
3. A nurse is providing education regarding risk factors for gout. What information should be provided?
One risk factor for gout is alcohol consumption due to the buildup of uric acid, also known as hyperuricemia. Foods or a diet that is high in purines such as livers, yeast, sardines, and anchovies can also be a risk factor for gout. Also having any of the following conditions can place a client at risk for having gout: obesity, hypertension, diabetes, kidney disease, and hypothyroidism.
4. A nurse is caring for a client who has been admitted with renal calculi. List three (3) interventions the nurse will take in the management of renal calculi.
3 interventions the nurse should implement when caring for a client with renal calculi include the following: monitor vital signs of the patient, paying attention to the client’s temperature as an elevated temperature could indicate infection in the patient. The nurse should also be sure to implement effective pain management for this client, clients with renal calculi tend to experience severe pain. Another intervention the nurse should implement for this patient is dietary teaching on appropriate foods and beverages for the client to eat and drink while having a renal calculus.
5. A nurse is caring for a client with pneumonia. What are three (3) physical assessment findings that are noted with the development of pneumonia?
During a physical assessment of a client with pneumonia the nurse may find that the client may be experiencing shortness of breath and crackles or wheezes heard upon auscultation. Upon inspection the patient may exhibit diaphoresis. This patient may also have fever and chills when experiencing pneumonia.
6. A nurse is caring for a client with colorectal cancer who is scheduled for a colectomy. What preoperative and post-operative education should be provided to this client?
Patients undergoing a colectomy will usually be required to do bowel prep before surgery. The nurse should instruct the client on the appropriate way to take the bowel prep, and be reminded to consume adequate fluids while doing the bowel prep. The patient should be instructed to stop taking aspirin containing medications or other blood thinning medications for 7 days prior to the procedure. The patient should also be informed of any other preoperative work ups the patient may need to attend such as a face to face with the anesthesiologist, or preop lab work that may need to be completed and reviewed by the physician prior to surgery. Following the procedure, the patient will need to know that most patients can expect to stay in the hospital for 3-5 days. The patient will also need to be educated on what an appropriate diet would be following this procedure. The nurse should also instruct the patient to refrain from any heavy lifting for at least two weeks following the surgery.
7. A nurse is caring for a client with multiple risk factors for peripheral vascular disease. List four (4) risk factors associated with peripheral vascular disease.
Four risk factors that can contribute to peripheral vascular disease would be obesity, history of smoking or is a current smoker, diabetes, and hypertension.
8. What laboratory values are associated with heparin-induced thrombocytopenia?
A patient experiencing heparin induced thrombocytopenia will have lab values that reflect a low platelet count, and an increased ptinr
9. A nurse is caring for a client with a spinal trauma who is experiencing neurogenic shock. What manifestations and nursing care measures should the nurse expect and take?
Clinical manifestations of neurogenic shock include: bradycardia, hypotension, paralytic ileus, decreased reflexes, and flaccid paralysis. The nurse should monitor patient vital signs especially for signs of hypotension and bradycardia. The nurse should also treat signs and symptoms appropriately with medications such as vasopressors or atropine.
10. A nurse is caring for a client with a spinal cord injury. What are possible causes of autonomic dysreflexia that the nurse should monitor for? [Show Less]