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Complications and Nursing Interventions

- Hemorrhage: monitor for bright red bleeding, increased clots, decreased urine output, or signs of shock; notify the doctor; increase CBI flow rate; administer fluids and blood transfusions as ordered

- Infection: monitor for fever, chills, dysuria, hematuria, or foulsmelling urine; notify the doctor; obtain urine culture; administer antibiotics as ordered

- Bladder injury: monitor for abdominal pain, distension, or leakage of urine around the catheter; notify the doctor; prepare for possible cystoscopy or surgical repair

- Electrolyte abnormalities: monitor for hyponatremia due to absorption of irrigating fluid; notify the doctor; restrict fluids; administer diuretics or hypertonic saline as ordered

- Erectile dysfunction: monitor for changes in sexual function; notify the doctor; provide emotional support; refer to counseling or treatment options as needed

- Retrograde ejaculation: monitor for dry orgasm or cloudy urine after ejaculation; notify the doctor; provide reassurance that this is not harmful and does not affect sexual pleasure; educate about fertility options if desired

Questions on Complications and Nursing Interventions

Correct Answer is C

Explanation

The lateral position with the affected side up is not the appropriate position for TURP surgery, as it does not provide the necessary access to the urinary tract.Questions

Correct Answer is A

Explanation

No explanation

Correct Answer is D

Explanation

This is the correct answer. Monitoring fluid intake and output during TURP surgery allows the nurse to assess for signs of fluid overload or imbalance, which can occur due to irrigation fluids and potential bleeding.

Correct Answer is C

Explanation

Retrograde ejaculation may occur after TURP, but it is not the most common postoperative complication.

Correct Answer is C

Explanation

Kegel exercises are helpful for strengthening the pelvic floor muscles but may not be the best intervention for addressing urinary urgency and frequency after TURP surgery. Anticholinergic medications are more appropriate in this case.

Correct Answer is B

Explanation

Initiating a rapid infusion of intravenous fluids may not be appropriate without a proper assessment and evaluation of the client's condition. The priority is to inform the surgical and anesthesia teams to address the situation promptly.

Correct Answer is A

Explanation

Administering an anticholinergic medication may be appropriate in some cases, but it is notthe primary intervention for urinary incontinence after TURP surgery. Pelvic floor exercises are a non-pharmacological approach to address the issue.

Correct Answer is C

Explanation

The client's educational background and employment status may not be directly relevant to TURP surgery and are not the priority during the preoperative assessment.

Correct Answer is D

Explanation

This is the correct answer. Monitoring fluid intake and output during TURP surgery allows the nurse to assess for signs of fluid overload or imbalance, which can occur due to irrigation fluids and potential bleeding.

Correct Answer is D

Explanation

This is the correct answer. Continuous bright red bleeding from the urinary catheter after TURP surgery may indicate bleeding complications that require immediate intervention and evaluation by the healthcare provider.

Correct Answer is C

Explanation

The catheter should not be replaced weekly unless there is a specific indication for catheter change. Catheter replacement should be done according to the healthcare provider's instructions and protocols.

Correct Answer is A

Explanation

Applying warm compresses to the abdomen may provide some comfort but does not address the underlying UTI.

Correct Answer is D

Explanation

This is the correct answer. Consuming caffeine and alcohol in moderation is recommended after TURP surgery. These substances can act as diuretics, increasing the need to urinate and potentially causing discomfort for the client.

Correct Answer is C

Explanation

Discharging a client on the same day of surgery is not standard practice for TURP, as immediate postoperative monitoring is necessary.

Correct Answer is B

Explanation

Restricting sodium intake may be appropriate in some cases, but the priority is to address the respiratory distress associated with fluid overload.

Correct Answer is B

Explanation

Initiating a rapid infusion of intravenous fluids may not be appropriate without a proper assessment and evaluation of the client's condition. The priority is to inform the surgical and anesthesia teams to address the situation promptly.

Correct Answer is D

Explanation

Avoiding driving for just one week may not be sufficient for proper recovery after TURP surgery.

Correct Answer is B

Explanation

<p>This response is incorrect. TURP is a surgical procedure and does not involve catheter insertion for drainage.</p>

Correct Answer is A

Explanation

Administering a blood-thinning agent to counteract the anticoagulant effects is not appropriate and can lead to complications. The healthcare provider should decide on the management of anticoagulation therapy before surgery.

This is the correct answer. Actively listening to the client's concerns allows the nurse to understand their fears and provide appropriate emotional support, which can help alleviate anxiety before TURP surgery.

Sexual dysfunction after TURP is typically temporary and not a permanent outcome.

While distractions can provide some comfort, they may not be enough to effectively manage postoperative pain. Pain medication is the primary intervention.

Assessing the client's surgical incision for signs of infection is essential, but it may not be the immediate priority during the immediate postoperative period. The focus should be on assessing vital signs and for signs of bleeding or other complications.Questions

Instructing the client to perform Kegel exercises is not the priority when the client is experiencing severe pain and inability to void after TURP surgery. The client's symptoms require prompt evaluation and intervention.

This is the correct answer. The client should gradually resume their regular activities as they tolerate, but they should avoid heavy lifting and strenuous exercises for a few weeks to promote healing and prevent complications after TURP.Questions

Administering pain medication may be necessary, but the priority is to address the bladder perforation and involve the surgical team to manage the complication.

Kegel exercises are beneficial for pelvic floor muscle strengthening but are not specifically required before TURP surgery.

Leaving dentures in place during surgery may not interfere with surgical instruments directly, but the main concern is the risk of aspiration.

Ensuring the client is medically fit for the surgery is crucial, but it is not the primary responsibility related to informed consent.

Removing the catheter the day after surgery may not be appropriate, as the client may still have difficulty urinating due to the effects of the surgery. The removal of the catheter is based on the client's ability to urinate comfortably and effectively.Questions

It is not appropriate for the nurse to dismiss the client's concerns. Erectile dysfunction is a valid concern for many clients undergoing TURP surgery.

<p>Avoiding heavy lifting and strenuous exercises for one week may not be sufficient for proper healing after TURP surgery.</p>

Leaving dentures in place during surgery may not interfere with surgical instruments directly, but the main concern is the risk of aspiration.

Local anesthesia alone may not be sufficient for pain relief during TURP surgery, as it involves a more extensive procedure that requires regional anesthesia to achieve better pain control.

Administering pain medication may be necessary, but the priority is to address the bladder perforation and involve the surgical team to manage the complication.

The lateral position with the affected side up is not the appropriate position for TURP surgery, as it does not provide the necessary access to the urinary tract.Questions

Deep breathing exercises can help manage pain, but the nurse should first address the client's acute symptoms and notify the healthcare provider for appropriate intervention.
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