A nurse is caring for a client who is undergoing initial peritoneal dialysis. Which of the following should the nurse report immediately to the provider?
Purulent dialysate outflow
Blood-tinged dialysate outflow
Report of fullness with dialysate dwelling
Report of discomfort during dialysate inflow
The Correct Answer is A
Rationale:
A. Purulent dialysate outflow is a sign of infection, specifically peritonitis, which is a serious complication of peritoneal dialysis that requires immediate medical attention.
B. Blood-tinged dialysate can occur, especially if the client is new to dialysis or has had recent abdominal surgery, but it should be monitored rather than immediately reported unless it is excessive.
C. A feeling of fullness during the dialysate dwelling phase is common and usually resolves as the body adjusts to the procedure.
D. Discomfort during dialysate inflow can occur, particularly with fast inflow rates or high dialysate volumes, but it is not immediately life-threatening.
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Correct Answer is A
Explanation
Rationale:
A. Airway patency is the highest priority following a thyroidectomy due to the risk of airway obstruction from swelling or hematoma formation near the surgical site. Compromised airway can lead to respiratory distress and requires immediate attention.
B. While monitoring temperature is important for detecting potential infections, it is not the immediate priority.
C. Pain control is important for comfort and recovery, but it is not life-threatening.
D. Urination should be monitored postoperatively, but it is not as critical as ensuring a patent airway.
Correct Answer is A
Explanation
Rationale:
A. Desmopressin is a synthetic analog of antidiuretic hormone (ADH) and is used to reduce urine output in conditions like diabetes insipidus. Monitoring urine output is the primary way to assess the effectiveness of this medication. A decrease in urine volume indicates the medication is working effectively.
B. Pupillary response is not relevant in assessing the effectiveness of desmopressin.
C. Temperature monitoring is important in general patient care but does not directly relate to the effectiveness of desmopressin.
D. Apical heart rate is important to monitor in many scenarios but is not a direct indicator of desmopressin's effectiveness.