Nokea
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.
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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.
Post transurethral resection of the prostate, a client has a three-way catheter with a continuous bladder irrigation. Over the last 12 hours, there has been 1400 ml of irrigation solution infused and 2000 ml measured in output from the drainage bag. What is the recording of the urinary output for the 12-hour period? (Record your answer using a whole number) ml.
Correct Answer: 600 ml
Rationale: 2000 ml from the drainage bag (including both the irrigation fluid and urine) minus the 1400 ml of irrigation fluid equals 600 ml of urine: 2000 ml - 1400 ml = 600 ml.
The nurse is teaching a client with benign prostatic hyperplasia (BPH). What statement indicates a lack of understanding by the client?
- A. There should be no problem with a glass of wine with dinner each night.
- B. I am so glad that I weaned myself off of coffee about a year ago.
- C. I need to inform my allergist that I cannot take my normal decongestant.
- D. My normal routine of drinking a quart of water during exercise needs to change.
Correct Answer: A
Rationale: This client did not associate wine with the avoidance of alcohol, and requires additional teaching. The nurse must teach a client with BPH to avoid alcohol, caffeine, and large quantities of fluid in a short amount of time to prevent overdistention of the bladder. Decongestants also need to be avoided to lower the chance for urinary retention.
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.
A client came to the clinic with erectile dysfunction. What are some possible causes of this condition that the nurse could discuss with the client during history taking?
- A. Recent prostatectomy
- B. Long-term hypertension
- C. Diabetes mellitus
- D. Hour-long exercise sessions
- E. Consumption of beer each night
Correct Answer: A,B,C,E
Rationale: Organic erectile dysfunction can be caused by surgical procedures, hypertension and its treatment, diabetes mellitus, and alcohol consumption. There is no evidence that exercise is related to this problem.