A nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP). The client reports sharp lower abdominal pain. Which of the following actions should the nurse take first?

Increase the client's fluid intake.

Check the client's urine output.

Reposition the client in bed.

Administer PRN pain medication.

Answer and Explanation

The Correct Answer is B

Continuous bladder irrigation (CBI) is a procedure that involves instilling sterile fluid into the bladder through a three-way catheter to prevent clot formation and maintain patency after a TURP surgery. The nurse should monitor the client's urine output closely and report any signs of obstruction such as decreased urine flow, blood clots, or abdominal pain.

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Correct Answer is B

Explanation

The client should expect less than 25 mL of secretions per day in the drainage devices before they are removed, usually within 7 to 10 days after surgery. This indicates that the wound is healing and there is no excessive fluid accumulation in the surgical site. The other statements are incorrect and indicate a need for further teaching. The client should not wait 2 months before additional saline can be added to the breast expander, as this may delay the reconstruction process and increase the risk of infection or contracture.

The client should keep the left arm elevated on a pillow and avoid flexing it at the elbow, as this may impair lymphatic drainage and cause edema or pain. The client should perform gentle range-of-motion exercises with the left arm and avoid lifting heavy objects such as a 15-pound weight, as this may strain the incision or cause bleeding.

A. Drink 3 L of fluids daily. B. Wipe the perineal area from front to back after urinating. C. Drink low-fructose cranberry juice. D. Take a warm bubble bath daily. E. Void every 6 hr during the day.

Correct Answer is ["A","B","C"]

Explanation

Drinking plenty of fluids helps flush out bacteria from the urinary tract and prevent urinary stasis . Wiping from front to back prevents contamination of the urethra with fecal bacteria . Cranberry juice may prevent bacterial adherence to the bladder wall and lower the pH of urine, making it less favorable for bacterial growth . However, cranberry juice should be low in fructose because high-fructose corn syrup may increase bacterial growth . Bubble baths may irritate the urethra and increase the risk of infection . Voiding frequently (every 2 to 3 hours) prevents urinary stasis and bacterial growth .

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A nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP). The client reports sharp lower abdominal pain. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client following a modified left radical mastectomy with breast expander. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is B

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