The postoperative client has an indwelling urinary catheter that was inserted in surgery. Which clinical indicator is an undesirable outcome related to the catheter?
1. The client is febrile 3 hours after the surgery.
2. Client complains of mild pressure in perineum.
3. The leukocyte count is 11,000 the next morning.
4. Urine has sediment on second postoperative day.
4
4. Cloudiness or sediment in the urine is consistent with clinical indicators of a uri-nary tract infection, an undesirable outcome for using the urinary catheter. The de-sired outcome is the client will have clear urine while catheter is in place.
1. When a client is febrile so soon after surgery, infection is rarely the cause unless the client went to surgery with the infection. Generally, an immediate postoperative fever indicates dehydration, atelectasis, and, on rare occasions, malignant hyperthermia.
2. Mild perineal pressure is common and usually benign while a client has an indwel-ling urinary catheter.
3. 11,000 is within the normal range for while blood cells; however, the nurse expects mild leukocytosis shortly after surgery, reflecting the inflammatory response of the body to the surgery as part of the healing process.
You might also like to view...
Bradypnea can be caused by which of the following? Select all that apply
a. Alcohol which depresses the respiratory center of the brain b. A higher metabolic rate occurring during normal sleep c. Medications which depress the respiratory center of the brain d. A lower metabolic rate occurring during normal sleep e. A lower metabolic rate occurring during strenuous exercise f. Head injury resulting in increased intracranial pressure in the respiratory center
To which age group do most hospitalized patients belong?
a. Infants b. Young adults c. Middle adults d. Older adults
A patient has had hip replacement surgery. What is the nurse's best plan to address this patient's ambulation needs?
1. Keep both bed rails up at all times so the patient will not attempt ambulation without assistance. 2. Teach the patient how to use a walker. 3. Have the patient practice log-rolling to the side of the bed before getting up. 4. Have the patient use a wheelchair until the hip is completely healed.
You are palpating the apical impulse in a patient with heart disease and find that the amplitude is diffuse and increased. Which of the following conditions could be a potential cause of an increase in the amplitude of the impulse?
A) Hypothyroidism B) Aortic stenosis, with pressure overload of the left ventricle C) Mitral stenosis, with volume overload of the left atrium D) Cardiomyopathy