A nurse assisting with the care of a client who is admitted to the medical-surgical unit.

The nurse is reviewing the client's laboratory findings and vital signs.

Select the 5 findings that require immediate follow-up.

A) A recent move to a new city: A move to a new city is an example of an external stressor. External stressors are environmental or situational factors that create stress, such as life changes, events, or challenges in the outside world. Relocating can involve significant adjustments, such as adapting to a new community, finding housing, and establishing new social connections, all of which can cause stress.

B) Lack of nutritional knowledge: Lack of nutritional knowledge is an internal stressor, as it involves an individual's beliefs, attitudes, and understanding. While it can cause stress, it is a personal factor rather than an external, environmental one.

C) Report of feeling depressed: Feelings of depression are an internal stressor because they are related to an individual’s emotional state or mental health. This reflects the client's internal experience rather than an external environmental factor.

D) Recurring urinary tract infections: Recurring urinary tract infections (UTIs) are a health-related concern and can be seen as a physiological stressor. However, they are not strictly external; they are related to the individual’s health and body rather than external environmental circumstances.

A) Occasional small clots in the urine:
Occasional small clots can be expected after a transurethral resection of the prostate (TURP) due to the surgical trauma to the prostate and surrounding tissues. However, any change in the nature or frequency of clots, or if they become larger, should be reported, but small clots are not immediately concerning in the early postoperative period.

B) Urine output of 300 mL over 8 hr:
This urine output is within a reasonable range. While urine output may be initially monitored closely after TURP, a volume of 300 mL over 8 hours does not constitute a concerning finding. It may be less than expected, but it is not an emergency. The nurse should continue to monitor urine output, but this is not immediately concerning unless the client has a significantly reduced or absent output.

C) Dark red urine:
Dark red urine is a concerning finding as it may indicate excessive bleeding or hemorrhage, especially within the first 24 hours after TURP. While some initial hematuria (blood in the urine) is common, the urine should not remain dark red or worsen. This could indicate active bleeding or a clot obstructing the urinary flow, which requires immediate intervention and reporting to the healthcare provider to prevent complications.

D) Frequent urge to urinate:
A frequent urge to urinate is not an unusual finding following TURP, as the bladder may be irritated due to the catheter or residual inflammation from the surgery. While it is a discomforting symptom, it is typically not an immediate concern and often resolves as the healing process progresses. However, persistent or painful urination may require further evaluation.