A nurse is planning care for a client who is 2 hours postoperative following a transurethral resection of the prostate (TURP). The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?
Restrict the client's oral fluid intake.
Remind the client he might feel a constant urge to void.
Monitor the client's urine output every 6 hours.
Weigh the client every evening.
The Correct Answer is B
Choice A reason:
Restricting the client's oral fluid intake is not typically recommended as part of postoperative care following TURP. In fact, maintaining adequate hydration is important to help flush the bladder and prevent clot formation.
Choice B reason:
It is common for clients to feel a constant urge to void due to the irritation of the bladder from the catheter and the continuous bladder irrigation. Reminding the client that this sensation is normal and expected can help alleviate anxiety and provide reassurance.
Choice C reason:
Monitoring the client's urine output is important to ensure that the bladder irrigation is effective and that there are no signs of obstruction. However, it should be done more frequently than every 6 hours, especially in the immediate postoperative period, to promptly detect any complications.
Choice D reason:
Weighing the client every evening is not directly related to the management of continuous bladder irrigation. While monitoring weight can be part of overall postoperative care, it does not address the specific needs related to TURP and continuous bladder irrigation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Asking about dietary changes is relevant to a skin assessment, as diet can influence skin health. However, this question does not require intervention unless the dietary changes are directly related to the skin condition. If the client has been advised to follow a specific diet for their skin condition, then the nurse should ensure compliance with that diet.
Choice B reason:
This question shifts the focus from the skin condition’s characteristics and impact to general coping mechanisms. It does not help determine the lesion’s symptoms, triggers, or functional effects, and thus does not align with a targeted skin assessment framework, requiring intervention.
Choice C reason:
Exploring how the skin issue affects the client’s feelings reveals psychosocial stressors and the emotional burden of living with a visible condition. This insight supports holistic care planning, adherence strategies, and therapeutic rapport.
Choice D reason:
Sleep disturbances can be a consequence of skin conditions, especially if they involve itching or pain. This question is pertinent to the assessment and does not require intervention. The information gathered can help in formulating a comprehensive care plan that addresses the client's comfort and sleep quality.
Correct Answer is C
Explanation
Choice A reason:
Danazol is a synthetic steroid that is typically used to treat endometriosis and fibrocystic breast disease. It is not indicated for the treatment of benign prostatic hyperplasia (BPH) and could potentially worsen symptoms due to its androgenic effects.
Choice B reason:
Methyltestosterone is an anabolic steroid with androgenic properties, similar to the male hormone testosterone. It is used to treat men with testosterone deficiency. However, it is not used for BPH treatment and, like danazol, could exacerbate BPH symptoms due to its androgenic activity.
Choice C reason:
Finasteride is a 5-alpha reductase inhibitor that is commonly prescribed for the treatment of BPH. It works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), a hormone that contributes to prostate growth. By reducing DHT levels, finasteride can help shrink the prostate and alleviate urinary symptoms associated with BPH.
Choice D reason:
Fluoxymesterone is another anabolic steroid with testosterone-like effects. It is used to treat conditions associated with a deficiency or absence of endogenous testosterone. It is not suitable for BPH treatment and could potentially worsen the condition due to its androgenic properties.
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