Question 1

Although each potential kidney transplant recipient is judged individually as a candidate,which condition from the list below would most likely eliminate a patient as a candidate for kidney transplant?

Accepted Answer

Each potential recipient is judged individually in regard to kidney transplantation.Most persons younger than 55 years are acceptable;older patients are less tolerant of postoperative complications.The following are contraindications for renal transplantation:systemic disease that precludes major surgery,oxalosis (a metabolic disorder),a positive HLA cytotoxic antibody screen,untreatable cardiovascular disease,active cancer,and noncompliance.

Question 2

TURP syndrome is a state of severe hyponatremia,caused by systemic absorption of irrigating fluid during the procedure.Select the sign/symptom that the anesthesia provider would report in a patient experiencing TURP syndrome.

Accepted Answer

Signs and symptoms such as sudden restlessness,apprehension,irritability,confusion,nausea,slow pulse rate,seizures,dysrhythmias,and rising blood pressure may be suggestive of TURP syndrome.This syndrome results in severe hyponatremia caused by systemic absorption of irrigating fluid used during surgery.

Question 3

Select the appropriate triad of corrective actions for the management of TURP syndrome in the intraoperative patient.

Accepted Answer

IV diuretics such as furosemide (Lasix)may be required to prevent possible pulmonary edema associated with administration of hypertonic saline.If the patient's reaction is severe,surgery may have to be terminated.The nurse monitors the amount of irrigation fluid recovered and subtracts it from the amount of irrigation fluid used.The total of the irrigation used minus the irrigation recovered is referred to as the volume deficit.If the cause for the deficit cannot be identified,it should be considered reabsorbed.

Question 4

The flexible cystoscope is a delicate and valuable endoscopic instrument indicated for diagnostic bladder evaluation for patients with obstructive symptoms from prostatic hyperplasia and a rigid prostatic urethra.It has valuable benefits because of its small diameter and flexibility.Select benefits that support the use of flexible endoscopy in the outpatient setting.

Accepted Answer

The flexible cystoscope is used for patients with obstructive symptoms resulting from prostatic hyperplasia and a rigid prostatic urethra.In addition,the flexible cystoscope can be used for patients who cannot assume a lithotomy position,such as those with spinal cord injuries or severe arthritis.Flexible cystoscopy may be accomplished with the use of a local anesthetic.It affords the patient a higher degree of comfort,is less traumatic to the urethra,and can be performed in the patient's bed on the nursing unit.The flexible cystoscope must be reprocessed with manual cleaning and high-level disinfection or sterilization.

Quiz 14: Genitourinary Surgery

Although each potential kidney transplant recipient is judged individually as a candidate,which condition from the list below would most likely eliminate a patient as a candidate for kidney transplant?

TURP syndrome is a state of severe hyponatremia,caused by systemic absorption of irrigating fluid during the procedure.Select the sign/symptom that the anesthesia provider would report in a patient experiencing TURP syndrome.

Select the appropriate triad of corrective actions for the management of TURP syndrome in the intraoperative patient.