Practice Quiz

NCLEX-RN

Category - Reduction of Risk

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A client was just transferred to a private room after a percutaneous transluminal coronary angioplasty. On a subsequent assessment, the nurse notes signs of bleeding in the dressing. What possible strategies should be utilized in order to prevent this complication?
  1. Instruct the client to cough to prevent atelectasis.
  2. Instruct the client to keep the legs straight for three hours.
  3. Administer pain medications on schedule.
  4. Monitor for bladder distention.
Explanation
Answer: D - Bleeding from the puncture site may be caused by bladder distention. The nurse is correct when she instructs the client to cough while the mouth is open to decrease abdominal pressure that could increase the blood pressure. The legs are kept straight for six hours to prevent occlusion of blood vessels. Pain medication should be given on schedule, but does not directly prevent bleeding. Other causes of bleeding after PTCA are vomiting, hypertension and leg bending.
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