Nokea
A 70-year-old client returned from a transurethral resection of the prostate 8 hours ago with a continuous bladder irrigation. The nurse reviews his laboratory results as follows: [Sodium data]. Which action should the nurse take?
- A. Consider starting a blood transfusion.
- B. Slow down the bladder irrigation if the urine is pink.
- C. Report the findings to the surgeon immediately.
- D. Take the vital signs every 15 minutes.
Correct Answer: B
Rationale: The serum sodium is decreased due to large-volume bladder irrigation (normal is 136 to 145 mEq/L). By slowing the irrigation, there will be less fluid overload and sodium dilution. The hemoglobin and hematocrit values are a low normal, with a slight decrease in the red blood cell count. Therefore, a blood transfusion or frequent vital signs should not be necessary. Immediate report to the surgeon is not necessary.
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The nurse is teaching an uncircumcised 65-year-old client about self-management of a urinary catheter in preparation for discharge to his home. What statement indicates a lack of understanding by the client?
- A. I only have to wash the outside of the catheter once a week.
- B. I should take extra time to clean the catheter site by pushing the foreskin back.
- C. The drainage bag needs to be changed at least once a week and as needed.
- D. I should pour a solution of vinegar and water through the tubing and bag.
Correct Answer: A
Rationale: The first few inches of the catheter must be washed daily starting at the penis and washing outward with soap and water. The other options are correct for self-management of a urinary catheter in the home setting.
A client is interested in learning about the risk factors for prostate cancer. Which factors does the nurse include in the teaching?
- A. Family history of prostate cancer
- B. Smoking
- C. Obesity
- D. Advanced age
- E. Eating too much red meat
- F. Race
Correct Answer: A,D,E,F
Rationale: Advanced family history of prostate cancer, age, a diet high in animal fat, and race are all risk factors for prostate cancer. Smoking and obesity are not known risk factors.
The nurse is administering sulfamethoxazole-trimethoprim (Bactrim) to a client diagnosed with bacterial prostatitis. Which finding causes the nurse to question this medication for this client?
- A. Urinary tract infection
- B. Allergy to sulfa medications
- C. Hematuria
- D. Elevated serum white blood cells
Correct Answer: B
Rationale: Before administering sulfamethoxazole-trimethoprim, the nurse must assess if the client is allergic to sulfa drugs. Urinary tract infection, hematuria, and elevated serum white blood cells are common problems associated with bacterial prostatitis that require long-term antibiotic therapy.
A 34-year-old client comes to the clinic with concerns about an enlarged left testicle and heaviness in his lower abdomen. Which diagnostic test would the nurse expect to be ordered to confirm testicular cancer?
- A. Alpha-fetoprotein (AFP)
- B. Prostate-specific antigen (PSA)
- C. Prostate acid phosphatase (PAP)
- D. C-reactive protein (CRP)
Correct Answer: A
Rationale: AFP is a glycoprotein that is elevated in testicular cancer. PSA and PAP testing is used in the screening of prostate cancer. CRP is diagnostic for inflammatory conditions.
The nurse is conducting a history on a male client to determine the severity of symptoms associated with prostate enlargement. Which finding is cause for prompt action by the nurse?
- A. Cloudy urine
- B. Urinary hestancy
- C. Post-void dribbling
- D. Weak urinary stream
Correct Answer: A
Rationale: Cloudy urine could indicate infection due to possible urine retention and should be a priority action. Common symptoms of benign prostatic hyperplasia are urinary hestancy, post-void dribbling, and a weak urinary stream due to the enlarged prostate causing bladder outlet obstruction.