Nurse Liza is assigned to care for a client who has returned to the nursing unit after left nephrectomy. Nurse Liza’s highest priority would be…
A. Hourly urine output
B. Temperature
C. Able to turn side to side
D. Able to sips clear liquid
Correct Answer: A. Hourly urine output
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.