After nephrectomy, it is necessary to measure urine output hourly. This is done to assess the effectiveness of the remaining kidney also to detect renal failure early. Immediately after surgery, the health care team will carefully watch the client’s blood pressure, electrolytes and fluid balance. These body functions are controlled in part by the kidneys. The client will most likely have a urinary catheter (tube to drain urine) in the bladder for a short time during the recovery.

Option B: Monitoring temperature regularly is recommended, but not the highest priority. The client may have discomfort and numbness (caused by severed nerves) near the incision area. Pain relievers are given after the surgical procedure and during the recovery period as needed. Although deep breathing and coughing may be painful because the incision is close to the diaphragm, breathing exercises are important to prevent pneumonia.
Option C: The client would be able to turn to his sides with some assistance after surgery. The client will probably remain in the hospital for 1 to 7 days, depending on the method of surgery used. He will be encouraged to return to light activities as soon as he feels up to it. Strenuous activity and heavy lifting should be avoided for 6 weeks following the procedure.
Option D: The client would be allowed to take sips of clear liquid as recommended by the physician. The doctor will give the client more detailed instructions about post-operative activities, restrictions and diet. Tests will be done on a regular basis to check how well the remaining kidney is working. A urinalysis (urine test) and blood pressure check should be done every year, and kidney function tests (creatinine, glomerular filtration rate [GFR]) should be checked every few years (or more often if abnormal results are found). Regular urine tests for protein should be performed as well. The presence of protein in the urine may mean that the kidney has some damage.

The lumen of the arteries can be assessed by cardiac catheterization. Angina is usually caused by narrowing of the coronary arteries. Left heart catheterization has a diagnostic as well as therapeutic role. Although it is used for cardiac hemodynamics and assessment of valvular lesions, its main diagnostic role is the assessment of coronary artery disease. In the contemporary era, left heart catheterization, especially selective coronary angiogram, is considered the gold standard test for coronary artery disease diagnosis.

Option A: Determining the existence of coronary heart disease includes tests and procedures such as echocardiogram, coronary angiography, blood tests, ECG, and MRI scans. Echocardiography is an ultrasound of the heart. It is a useful and non-invasive mode of testing that is performed in both acute and chronic and inpatient and outpatient settings. In acute settings, it could tell about wall motion, valvular regurgitation and stenosis, infective or autoimmune lesions, and chamber sizes.
Option C: Heart chamber pressure can be checked through cardiac catheterization but it is not the primary purpose. In non ACS settings, patients with intermediate pretest probability for CAD are usually the right candidates for it. In the ACS setting, all STEMI patients and selected NSTEMI patients get an emergent cardiac catheterization. This procedure is done in a cardiac catheterization lab, is expertise dependent, and is done under moderate sedation. There is contrast exposure in the procedure which could cause serious allergic reactions and kidney injury.
Option D: The oxygen saturation of the blood can be checked through a pulse oximeter. A pulse oximeter can measure oxygen saturation. It is a noninvasive device placed over a person’s finger. It measures light wavelengths to determine the ratio of the current levels of oxygenated hemoglobin to deoxygenated hemoglobin. The use of pulse oximetry has become a standard of care in medicine. It is often regarded as a fifth vital sign.

Blood pressure is monitored to detect hypotension which may indicate shock or hemorrhage. The apical pulse is taken to detect arrhythmias related to cardiac irritability. During the procedure, a nurse is assigned to monitor vital signs. After the procedure, the nurse is also responsible for ensuring that the access site is not bleeding and the distal extremity pulses are intact.

Option A: Patients should be kept lying flat for several hours after the procedure so that any serious bleeding can be avoided. Identification of the bleeding source is essential for patients with continued hemodynamic deterioration. These life-threatening bleeds are more frequent when the artery is punctured above the inguinal ligament. Most patients are managed with a reversal of anticoagulation, application of manual compression and volume resuscitation, and observation.
Option B: Coughing and deep breathing every 2 hours is unnecessary. For any patient, the complication rate is dependent on multiple factors and is dependent on the demographics of the patient, vascular anatomy, comorbid conditions, clinical presentation, the procedure being performed, and the experience of the operator. The complications can be minor as discomfort at the site of catheterization to major ones like death.
Option D: Temperature can be monitored for every shift. Cardiac catheterization is performed using sterile technique, and local or systemic infection is extremely rare. Routine prophylaxis for endocarditis is not recommended during cardiac catheterization procedures.

Protamine Sulfate is used to prevent continuous bleeding in a client who has undergone open heart surgery. Protamine is a medication used to reverse and neutralize the anticoagulant effects of heparin. Protamine is the specific antagonist that neutralizes heparin-induced anticoagulation. Protamine is a strongly alkaline (nearly two-thirds of the amino acid composition is arginine) polycationic low-molecular-weight protein found in salmon sperm that is also currently available in a recombinant form.

Option B: Quinidine sulfate is used to treat or prevent many types of irregular heartbeats such as atrial fibrillation. Quinidine can greatly improve the ability to perform normal activities by decreasing the number of irregular heartbeats. However, it may not stop all irregular heartbeats completely. It works by blocking abnormal heartbeat signals.
Option C: Vitamin C, or ascorbic acid, has several important functions: helping to protect cells and keeping them healthy, maintaining healthy skin, blood vessels, bones, and cartilage, and helping with wound healing.
Option D: Coumadin is used to treat blood clots and/or prevent new clots from forming in the body. Preventing harmful blood clots helps to reduce the risk of a stroke or heart attack. Conditions that increase the risk of developing blood clots include a certain type of irregular heart rhythm (atrial fibrillation), heart valve replacement, recent heart attack, and certain surgeries (such as hip/knee replacement).

The use of an electric toothbrush, irrigation device or dental floss may cause bleeding of gums, allowing bacteria to enter and increasing the risk of endocarditis. Maintaining good oral hygiene and infection control can decrease the incidence of endocarditis in the moderate-risk group of patients and can eliminate the necessity of antibiotic prophylaxis of endocarditis.

Option A: Dental floss may injure the gums and cause bleeding that may lead to infection. The gums become inflamed (red and swollen) and often bleed during tooth brushing, flossing, or certain dental procedures involving manipulation of the gums. When gums bleed, the bacteria can enter the bloodstream and can infect other parts of the body.
Option B: Electronic toothbrushes cause too much friction to the gums and cause an infection that can increase the risk of endocarditis. In very rare cases, bacteria in the mouth may trigger endocarditis in people at higher risk. Here’s what happens: Bacteria found in tooth plaque may multiply and cause gingivitis (gum disease).
Option D: An irrigation device uses a stream of pressurized, pulsating water to clean between teeth and below the gum line. The water’s pressure may cause injury to sensitive gums and lead to bleeding or an infection. To prevent endocarditis, patients with certain heart conditions receive a single dose of an antibiotic. The patient receives it about one hour prior to certain dental treatments.