Question

A percutaneous renal biopsy is scheduled for a client with chronic glomerulonephritis. Following the procedure the nurse should give priority to: A. Observing the client for post biopsy bleeding B. Checking the urinary specific gravity C. Providing medication for pain D. Encouraging the client to remain in bed for an hour

Short answer

Answer: A. Observing the client for post biopsy bleeding.

Step-by-step solution

Identify the procedure and its potential complications

The patient has just undergone a percutaneous renal biopsy due to chronic glomerulonephritis. This is an invasive procedure where a small sample of kidney tissue is removed for testing. The main potential complications after this procedure are post-biopsy bleeding and pain.

Evaluate each answer choice

Now, let's discuss each answer choice and determine if it meets the priority criteria following a percutaneous renal biopsy. A. Observing the client for post biopsy bleeding: This is a critical assessment as post-biopsy bleeding is a significant risk after a renal biopsy. This choice could be the priority. B. Checking the urinary specific gravity: While this may be important in assessing kidney function, it is not the immediate priority after this invasive procedure. C. Providing medication for pain: Addressing the patient's pain may be important, but it shouldn't be prioritized over assessing for potential bleeding. D. Encouraging the client to remain in bed for an hour: Ensuring the patient rests after the procedure is a relevant intervention, but it doesn't take precedence over monitoring for post-biopsy complications.

Determine the correct answer

From our evaluation of the answer choices, it's evident that option A (Observing the client for post biopsy bleeding) should be the priority. This is because post-biopsy bleeding is one of the main potential complications that need to be addressed immediately following a renal biopsy.

Key concepts

Post-Biopsy Complication Assessment

When a patient undergoes a percutaneous renal biopsy, nursing priorities shift to closely monitor for any adverse effects post-procedure. The most acute concern is post-biopsy bleeding, which can present as blood in the urine, a drop in blood pressure, or signs of internal bleeding. It's essential for the nurse to observe the patient for these symptoms to catch any hemorrhagic complications early, ensuring that appropriate interventions begin promptly if necessary.

Moreover, it's not just about spotting visible blood; subtle signs such as increasing discomfort, a feeling of fullness in the abdomen, or changes in vital signs can also indicate bleeding. In addition to vigilant observation, it's critical to educate the patient on what to watch for and to maintain open communication for reporting any distress. Pain assessment and management follow in importance, as well as ensuring that the patient remains on bed rest — typically for several hours — to reduce the risk of exacerbating any potential bleeding site.

Chronic Glomerulonephritis Management

Managing chronic glomerulonephritis involves a comprehensive approach targeting the reduction of symptoms, slowing disease progression, and diminishing the risk of complications. Dietary adjustments, such as monitoring protein intake and maintaining a low-sodium diet, are commonly recommended.

Pharmacologic therapy may include antihypertensive medications, diuretics, and potentially immunosuppressants, depending on the underlying cause of the nephritis. Patient education is pivotal for effective disease management. They must understand the importance of medication adherence, regular monitoring of kidney function through labs such as serum creatinine and urine tests, and being conscious of changes in urine output and fluid retention.

Furthermore, coordination with a multi-disciplinary team including nephrologists, dietitians, and possibly social workers offers a support system for the patient, enhancing overall care and helping to manage this chronic condition.

NCLEX-PN Test Preparation

Preparation for the NCLEX-PN (National Council Licensure Examination-Practical Nurse) is a process that requires an understanding of the exam format and content. Prospective nurses should focus on creating a study plan that includes reviewing core nursing content, such as pharmacology, medical-surgical nursing, and patient care. It's beneficial to incorporate various study methods, including practice questions and simulation exams, to become familiar with the question style and pacing of the test.

Important topics like nursing ethics, documentation, and patient rights are also essential. Study groups can offer support and collaborative learning opportunities, while professional prep courses can provide a structured and comprehensive review. Prioritizing difficult areas for additional study and consistently evaluating progress will help reinforce knowledge and build confidence as test day approaches. Time management, self-care during preparation, and test-taking strategies are crucial to excel on the exam.