Nokea
A patient has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The patient has a continuous bladder irrigation system in place. The patient tells you he is experiencing bladder spasms and asks what you can do to relieve his discomfort. What is the most appropriate nursing action to relieve the discomfort of the patient?
- A. Apply a cold compress to the pubic area.
- B. Notify the urologist promptly.
- C. Irrigate the catheter with 30 to 50 mL of normal saline as ordered.
- D. Administer a smooth-muscle relaxant as ordered.
Correct Answer: D
Rationale: Smooth-muscle relaxants, often ordered PRN post-TURP, relieve bladder spasms by reducing irritability. Cold compresses, urologist notification, or catheter irrigation do not directly address spasms.
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A patient has just returned to the floor following a transurethral resection of the prostate. A triple-lumen indwelling urinary catheter has been inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens?
- A. Continuous inflow and outflow of irrigation solution
- B. Intermittent inflow and continuous outflow of irrigation solution
- C. Continuous inflow and intermittent outflow of irrigation solution
- D. Intermittent flow of irrigation solution and prevention of hemorrhage
Correct Answer: A
Rationale: The triple-lumen catheter supports continuous bladder irrigation with one lumen for balloon inflation, one for irrigation solution inflow, and one for outflow to prevent clot formation and maintain patency.
A nurse is providing care for a patient who has recently been admitted to the postsurgical unit from PACU following a transurethral resection of the prostate. The nurse is aware of the nursing diagnosis of Risk for Imbalanced Fluid Volume. In order to assess for this risk, the nurse should prioritize what action?
- A. Closely monitoring the input and output of the bladder irrigation system
- B. Administering parenteral nutrition and fluids as ordered
- C. Monitoring the patients level of consciousness and skin turgor
- D. Scanning the patients bladder for retention every 2 hours
Correct Answer: A
Rationale: Continuous bladder irrigation post-TURP requires close monitoring of input and output to prevent fluid volume excess or deficit from occlusion or bleeding. Parenteral nutrition is unnecessary, skin turgor is unreliable, and bladder scanning is not needed with a catheter.
A 35-year-old father of three tells the nurse that he wants information on a vasectomy. What would the nurse tell him about ejaculate after a vasectomy?
- A. There will be no ejaculate after a vasectomy, though the patients potential for orgasm is unaffected.
- B. There is no noticeable decrease in the amount of ejaculate even though it contains no sperm.
- C. There is a marked decrease in the amount of ejaculate after vasectomy, though this does not affect sexual satisfaction.
- D. There is no change in the quantity of ejaculate after vasectomy, but the viscosity is somewhat increased.
Correct Answer: B
Rationale: Vasectomy does not significantly reduce ejaculate volume (only a 3% decrease) as seminal fluid is produced by the prostate and seminal vesicles, unaffected by the procedure. Viscosity remains unchanged, and orgasm potential is preserved.
A patient has experienced occasional urinary incontinence in the weeks since his prostatectomy. In order to promote continence, the nurse should encourage which of the following?
- A. Pelvic floor exercises
- B. Intermittent urinary catheterization
- C. Reduced physical activity
- D. Active range of motion exercises
Correct Answer: A
Rationale: Pelvic floor exercises strengthen muscles supporting the bladder, aiding continence post-prostatectomy. Catheterization is unnecessary and risky, and physical activity levels do not directly impact continence.
A patient who is scheduled for an open prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurses response?
- A. Erectile dysfunction is common after prostatectomy as a result of hormonal changes.
- B. All prostatectomies carry a risk of nerve damage and consequent erectile dysfunction.
- C. Erectile dysfunction after prostatectomy is expected, but normally resolves within several months.
- D. Modern surgical techniques have eliminated the risk of erectile dysfunction following prostatectomy.
Correct Answer: B
Rationale: Prostatectomies risk damaging pudendal nerves, leading to permanent erectile dysfunction in some cases. Hormonal changes are not the cause, resolution is not guaranteed, and modern techniques reduce but do not eliminate the risk.