What activates the afferent pathways causing the patient to feel pain?

Choice A rationale

Sharing a personal password, even with a nurse manager, violates security protocols established to protect patient confidentiality under the Health Insurance Portability and Accountability Act (HIPAA) and the facility's data integrity. Each user is accountable for actions performed under their unique login credentials, and sharing compromises this accountability and audit trail.

Choice B rationale

A password is a confidential key that verifies a user's identity and access permissions within the electronic health record (EHR) system. Sharing it with anyone compromises the security of patient data, violates privacy laws (HIPAA), and undermines the accountability associated with charting and order entry, thus posing a significant risk.

Choice C rationale

The unit clerk typically requires their own set of credentials based on their job role and necessary access levels. Sharing a nurse's password with the unit clerk allows unauthorized access to clinical data or functions beyond their scope of practice, which is a direct violation of data security policies and professional ethics.

Choice D rationale

The Information System (IS) representative has system-level access and procedures for password resets or temporary access when needed, but they do not require or request a user's personal password for normal operations. Sharing it with IS still constitutes a breach of personal accountability and strict security policies designed to protect sensitive patient information.

Choice A rationale

While increasing fluid intake is important for maintaining hydration and promoting urine flow after a TURP, this action will not resolve an immediate mechanical obstruction causing an abrupt cessation of output. The immediate concern is the buildup of fluid pressure in the bladder, which can lead to bladder spasm and hemorrhage.

Choice B rationale

A lack of output following a TURP with continuous bladder irrigation (CBI) most commonly indicates an occlusion of the catheter lumen, often by a blood clot or tissue fragments. Determining the patency, usually by gentle manual irrigation with sterile saline, is the priority to prevent dangerous bladder distension and potential hemorrhage from increased intravesical pressure.

Choice C rationale

Administering a prescribed analgesic may relieve pain due to bladder spasms, which can accompany obstruction, but it does not address the underlying mechanical cause. The immediate, life-threatening risk is bladder rupture or severe hemorrhage if the obstruction is not rapidly cleared.

Choice D rationale

Notifying the provider is a necessary step if the nurse cannot resolve the occlusion or if there are signs of escalating complications (e.g., severe hemorrhage, pain, or bladder distension). However, the nurse must first attempt to resolve the most common and immediate cause, which is a catheter blockage.