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HESI Remediation(NCLEX-PN)

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HESI Remediation(NCLEX-PN)NCLEX-PN Remediation Elimination  A male client reports dysuria, nocturia, and difficulty starting the urinary stream. Acystoscopy and biopsy of the prostate gland have been scheduled. After the procedure the client reports an inability to void. What should the nurse...

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  • August 11, 2023
  • 67
  • 2023/2024
  • Exam (elaborations)
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  • HESI Remediation
  • HESI Remediation
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Agradestuvia
DownloadedbyMaryWambui.(marywambui7925@yahoo.com)lOMoARcPSD|12311162
HESIRemediationNclexPN2022
MedicalSurgical(TheUniversityofTexasatArlington)Agradestuvia lOMoARcPSD|12311162
DownloadedbyMaryWambui.(marywambui7925@yahoo.com)HESIRemediation(NCLEX-PN)
NCLEX-PNRemediation
Elimination
Amaleclientreportsdysuria,nocturia,anddifficultystartingtheurinarystream.A
cystoscopyandbiopsyoftheprostateglandhavebeenscheduled.Afterthe
proceduretheclientreportsaninabilitytovoid.Whatshouldthenursedo?
Rationale:Palpateabovethepubicsymphysis
Afullbladderispalpablewithurinaryretentionanddistention,whicharecommon
problemsafteracystoscopybecauseofurethraledema.Fluidsdilutetheurineandreduce
thechanceofinfectionaftercystoscopyandshouldnotbelimited.Althoughurinary
retentioncanoccur,itisnotexpected;thenursemustassesstheextentofbladder
distentionanddiscomfort.Moreconservativenursingmethods,suchasrunningwateror
placingawarmclothovertheperineum,shouldbeattemptedtoprecipitatevoiding;
catheterizationcarriesariskofinfection.
Anurseisobtainingahealthhistoryfromthemotherofa15-month-oldtoddler
withceliacdisease.Thenurseexpectsthemothertoindicatewhatabouther
toddler?
Rationale:Hasbulky,foul,frothystools
Steatorrhea(fatty,foul-smelling,frothy,bulkystools)occurswithceliacdiseasebecause
ofanintolerancetogluten;toxicsubstances,whichcandamagetheintestinalmucosal
cells,accumulateandcausediarrhea.Drinkinglargeamountsoffluidisaresponseto
dehydration.Withceliacdiseasesomethirstmayoccur,butitisnotcontinuous.
Althoughinfantswithceliacdiseaseareirritable,thissignistoovagueforaccurate
evaluation.Irritabilityissymptomaticofavarietyofproblems,rangingfromcuttingof
teethtoleukemia.Concentratedurineisassociatedwithaurinarytractinfectionor
dehydration;thissignistoovaguetopermitaccurateevaluation.
Aclientwithanilealconduitisbeingpreparedfordischarge.Aspartofthe
dischargeteaching,whatdoesthenurseinstructtheclienttodo?
Rationale:Maintainfluidintakeofatleast2Ldaily
High-fluidintakeflushestheilealconduitandpreventsinfectionandobstructioncaused
bymucusoruricacidcrystals.Alcoholisnotcontraindicatedwithanilealconduit.Agradestuvia lOMoARcPSD|12311162
DownloadedbyMaryWambui.(marywambui7925@yahoo.com)Notifyingthehealthcareproviderifthestomasizedecreasesisexpected;asedema
decreases,thestomawillbecomesmaller.Soapandwaterontheperistomalareahelp
preventirritationfromwasteproducts.
Aclientisscheduledforatransurethralresectionoftheprostate(TURP).Which
statementmadebytheclientmostindicatestheneedforfurtherpreoperative
teaching?
Rationale:"Myincisionwillprobablybepainful"
TheTURPprocedureisperformedbyinsertionofascopedeviceintotheurethratoreach
theprostatefromwithintheurinarytract.Noincisionismadetoreachtheprostate,
thereforetheclientstatementaboutanincisionbeingpainfulaftersurgerywarrants
furtherevaluatingandteachingbythenurse.Theclientisdemonstratingcorrect
knowledgeabouttheTURPprocedurebystatingthataftersurgeryhisurinewillbered,
hewillhaveacatheter,andhewillneedtoincreasefluidintake.
Ahealthcareproviderprescribesbisacodyl(Dulcolax)foraclientwithcardiac
disease.Thenurseexplainstotheclientthatthisdrugactsbydoingwhat?
Rationale:Stimulatingperistalsis
Bisacodylstimulatesnerveendingsintheintestinalmucosa,precipitatingabowel
movement.Bisacodylisnotabulkcathartic.Bulk-forminglaxatives,suchaspsyllium
hydrophilicmucilloid(Metamucil),formsoft,pliantbulkthatpromotesphysiological
peristalsis.Bisacodylisnotastoolsoftener.Stoolsofteners,suchasdocusatesodium,
permitfatandwatertopenetratefeces,whichsoftensanddelaysthedryingofthefeces.
Bisacodylisnotanemollient.Emollientlaxatives,suchasmineraloil(Kondremul),
lubricatethefecesanddecreaseabsorptionofwaterfromtheintestinaltract.
Amaleclientwithabrainattack(cerebrovascularaccident)hasregainedcontrolof
bowelmovementsbutstillisincontinentofurine.Tohelpreestablishbladder
control,thenurseshouldencouragetheclienttodowhat?
Rationale:Assumeastandingpositionforvoiding
Assumingastandingpositionforvoidingreducestension(physicalandpsychological),
facilitatesthemovementofurineintothelowerportionofthebladder,andrelaxesthe
externalsphincter(increasingpressureandinitiatingthemicturitionreflex).Bladder
trainingshouldbeinstitutedbyencouragingvoidingeveryonetotwohoursand
progressivelyincreasingthetimebetweenattempts.Voidingshouldbeencouragedat
regularandfrequentintervalsduringwakinghours,notjustintheafternoon.Fourlitersis
alargefluidintakeandisunnecessary;itwillresultinalargevolumeofurine,probably
increasingthefrequencyofincontinence.Agradestuvia lOMoARcPSD|12311162
DownloadedbyMaryWambui.(marywambui7925@yahoo.com)AnurseiscaringforaclientwithaT-tubeafteranopencholecystectomy.What
specificactionshouldthenurseincludeintheplanofcare?
Rationale:Monitorthecolorofthestool
AT-tubemaintainspatencyofthecommonbileductuntilinflammationsubsides;when
theductispatentandbileentersthegastrointestinaltract,thecolorofstoolisbrown.
Anklepumpingpreventsvenousstasisifaclientisnotabletoambulate.Absenceofbile
affectstheabilitytodigestfats,notcarbohydrates.AT-tubedrainsbygravity;itisnota
self-containedsuctiondevicelikeaHemovac,socompressionisnotnecessary.
Afour-year-oldchildwithanewcolostomyistobedischargedinseveraldays.
Whatshouldthenurseteachtheparentsabouttheirchild'shomecare?
Rationale:Encouragingphysicalactivity
Contactgamesmayberestricted,butotherphysicalactivitiesshouldbeencouraged.The
stomashouldbeinspectedmoreoftenthanoncedailytoensureadequatecirculation.
Increasedfluidintakeisneededtocompensateforfecalfluidloss.Thedietshouldnotbe
restrictedatthetimeofdischarge.Boththeparentsandthechildwilllearnwhichfoods
arepoorlytolerated,andtheywilladjustthedietaccordingly.
Anurseisassessingaclientwithhypothyroidism.Whichclinicalmanifestations
shouldthenurseexpecttheclienttoexhibit?Selectallthatapply.
Rationale:Coolskin,constipation,periorbitaledema,anddecreasedappetite
Coolskinisrelatedtothedecreasedmetabolicrateassociatedwithinsufficientthyroid
hormone.Constipationresultsfromadecreaseinperistalsisrelatedtothereductioninthe
metabolicrateassociatedwithhypothyroidism.Periorbitalandfacialedemaarecaused
bychangesthatcausemyxedemaandthird-spacefluideffusionseeninhypothyroidism.
Decreasedappetiteisrelatedtometabolicandgastrointestinalmanifestationsofthe
hypothyroidism.
Aclientisscheduledforligationofhemorrhoids.Whichdietdoesthenurseexpect
tobeprescribedinpreparationforthissurgery?
Rationale:Low-residue
Alow-residuedietlimitsstoolformation.Blanddietsusuallyareemployedinthe
managementofupper,notlower,gastrointestinaldisturbances.AlthoughacleardietisAgradestuvia

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