Evolve: Urinary/Reproductive System

The nurse determines that which genitourinary factor contributes to urinary incontinence in older adults? 1 Sensory deprivation 2 Urinary tract infection 3 Frequent use of diuretics 4 Inaccessibility of a bathroom

2 Urinary tract infection

A client is scheduled for a transurethral resection of the prostate. What should the nurse tell the client to expect after surgery? 1 "Urinary control may be permanently lost to some degree." 2 "An indwelling urinary catheter is required for at least a day." 3 "Your ability to perform sexually will be impaired permanently." 4 "Burning on urination will last while the cystotomy tube is in place."

2 "An indwelling urinary catheter is required for at least a day."

A client who is dehydrated is to receive an intravenous (IV) solution of normal saline to be infused at 175 mL/hr. The drop factor of the IV set is 15 gtts/mL. At what drop rate should the nurse adjust the flow to provide the prescribed solution? Record your answer using a whole number. __________ gtts/min

44 gtts/min is a correct calculation. Multiply the amount of fluid to be infused (175 mL) by the drop factor (15) and divide this result by the amount of time in minutes (1 hr x 60 min).

A client weighed 210 pounds on admission to the hospital. After two days of diuretic therapy, the client weighs 205.5 pounds. How many liters of fluid has the client excreted? Record the answer using a whole number. Record your answer using a whole number. __________ liters

One liter of fluid weighs approximately 2.2 pounds; therefore, a 4.5-pound weight loss equals approximately 2 liters.

A client is admitted to the hospital for acute gastritis and ascites secondary to alcoholism and cirrhosis. It is most important for the nurse to assess this client for: 1 Blood in the stool 2 Food intolerances 3 Complaints of nausea 4 Hourly urinary output

1 Blood in the stool Erosion of blood vessels may lead to hemorrhage, a life-threatening situation further complicated by decreased prothrombin production, which occurs with cirrhosis.

A nurse concludes that the anemia that accompanies chronic kidney disease should be treated because it contributes to: 1 Uremic frost 2 Chronic fatigue 3 Tubular necrosis 4 Dependent edema

2 Chronic fatigue

A client reports to a health clinic because a sexual partner recently was diagnosed as having gonorrhea. The health history reveals that the client has engaged in receptive anal intercourse. The nurse should assess the client for: 1 Melena 2 Anal itching 3 Constipation 4 Ribbon-shaped stools

2 Anal itching

A nurse is caring for a client with chronic kidney failure. What should the nurse teach the client to limit the intake of to help control uremia associated with end stage renal disease (ESRD)? 1 Fluid 2 Protein 3 Sodium 4 Potassium

2 Protein The waste products of protein metabolism are the main cause of uremia. The degree of protein restriction is determined by the severity of the disease.

When performing a peritoneal dialysis procedure, the nurse should: 1 Place the client in a side-lying position 2 Warm dialysate solution slightly before instillation 3 Infuse the dialysate solution slowly over several hours 4 Withhold the routine medications until after the procedure

2 Warm dialysate solution slightly before instillation The infusion should be warmed to body temperature to lessen abdominal discomfort and promote dilation of peritoneal vessels. The side-lying position may restrict fluid inflow and prevent maximum urea clearance; the client should be placed in the semi-Fowler position. The infusion of dialysate solution should take approximately 5 to 10 minutes. Routine medications should not interfere with the infusion of dialysate solution.

A female client who has recurrent urinary tract infections (UTIs) is inquiring about the prevention of future UTIs. What information should the nurse include when teaching the client? (Select all that apply.) 1 Avoid fluid intake after 6 pm 2 Drink 8 to 10 glasses of water each day 3 Urinate immediately after sexual intercourse 4 Increase the daily intake of carbonated beverages 5 Clean the perineal area with an astringent soap twice a day

2 Drink 8 to 10 glasses of water each day 3 Urinate immediately after sexual intercourse

A nurse is caring for a client with a ureteral calculus. Which are the most important nursing actions? (Select all that apply.) 1 Limiting fluid intake at night 2 Monitoring intake and output 3 Straining the urine at each voiding 4 Recording the client's blood pressure 5 Administering the prescribed analgesic

2 Monitoring intake and output 3 Straining the urine at each voiding 5 Administering the prescribed analgesic

A nurse is caring for a client with an undescended testicle. The nurse teaches the client that the main reason why the testicles are suspended in the scrotum is to: 1 Protect the sperm from the acidity of urine. 2 Facilitate the passage of sperm through the urethra. 3 Protect the sperm from high abdominal temperatures. 4 Facilitate their maturation during embryonic development

3 Protect the sperm from high abdominal temperatures. Sperm cells are fragile and can be destroyed by heat, causing sterility.

A client with cancer of the prostate requests the urinal at frequent intervals but either does not void or voids in very small amounts. What does the nurse conclude is most likely the causative factor? 1 Edema 2 Dysuria 3 Retention 4 Suppression

3 Retention

A client who is to begin continuous ambulatory peritoneal dialysis (CAPD) asks the nurse what this treatment entails. What information should the nurse include in the explanation? 1 Peritoneal dialysis is done in an ambulatory care clinic. 2 Hemodialysis and peritoneal dialysis are provided continuously. 3 The peritoneal membrane allows passage of toxins into the dialysate. 4 A quarter of a liter of dialysate is maintained inter- and intraperitoneally.

3 The peritoneal membrane allows passage of toxins into the dialysate.

A nurse is planning to administer a prescribed intravenous solution that contains potassium chloride. What assessment should be brought to the health care provider's attention before administration of the intravenous (IV) line? 1 Uncharacteristic irritability 2 Poor tissue turgor with tenting 3 Urinary output of 200 mL during the previous 8 hours 4 Oral fluid intake of 300 mL during the previous 12 hours

3 Urinary output of 200 mL during the previous 8 hours Decreased urinary output will result in the retention of potassium, causing hyperkalemia. Reporting uncharacteristic irritability is unnecessary; this is a sign of dehydration, which can be corrected with appropriate hydration.

To facilitate micturition in a male client, the nurse should instruct him to: 1 Use a urinal for voiding 2 Drink cranberry juice daily 3 Wash the hands after voiding 4 Assume the standing position for voiding

4 Assume the standing position for voiding Assuming the standing position for voiding uses gravity to allow urine to exert pressure on the area of the trigone, initiating relaxation of the urinary sphincter and facilitating micturition.

A nurse is caring for a client who is experiencing urinary incontinence. The client has an involuntary loss of small amounts (25 to 35 mL) of urine from an overdistended bladder. This should be documented in the medical record as: 1 Urge incontinence 2 Stress incontinence 3 Reflex incontinence 4 Overflow incontinence

4 Overflow incontinence

An older adult client is demonstrating mild confusion after surgical repair of a hernia. What should the nurse do to provide for this client's safety? 1 Use a nightlight in the client's room. 2 Secure a prescription for a soft vest restraint. 3 Activate the position-sensitive bed alarm. 4 Raise the four side rails on the client's bed

3 Activate the position-sensitive bed alarm.

A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for what complication? 1 Peritonitis 2 Renal calculi 3 Hepatitis B 4 Bladder infection

3 Hepatitis B Hepatitis type B is transmitted by blood or blood products. The hemodialysis and routine transfusions needed for a client in end-stage renal failure constitute a high risk for exposure.

A nurse is caring for a client who had a kidney transplant. Which test is most important for determining whether a client's newly transplanted kidney is working effectively? 1 Renal scan 2 Serum creatinine 3 24-hour urine output 4 White blood cell (WBC) count

2 Serum creatinine

A client who had a suprapubic prostatectomy returns from the post-anesthesia care unit and accidentally pulls out the urethral catheter. What should the nurse do first? 1 Reinsert a new catheter. 2 Notify the health care provider. 3 Check for bleeding by irrigating the suprapubic tube. 4 Take no immediate action if the suprapubic tube is draining.

2 Notify the health care provider. The catheter must be reinserted by the health care provider to ensure bladder emptying, maintain pressure at the operative site, and prevent hemorrhage. Because of the danger of further trauma to the urethra and surgical site, the health care provider should insert the catheter.

A nurse is caring for a client who is being treated with continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis. What dietary need should the nurse discuss with the client? 1 Low-calorie foods 2 High-quality protein 3 Increased fluid intake 4 Foods rich in potassium

2 High-quality protein Although proteins may be restricted, those eaten should be high-quality proteins that are used to replace proteins lost during dialysis. A high-caloric intake should be encouraged. Increased fluid intake is inappropriate; fluids usually are restricted moderately because of impaired renal function. Foods rich in potassium are inappropriate; high-potassium foods are restricted because of impaired renal function.

The nurse is caring for a client four days after the client had a cystectomy and formation of a continent diversion. After observing mucous threads in the client's urine, the nurse should: 1 Recognize that this is an expected response 2 Report this to the health care provider immediately 3 Obtain a specimen for culture and sensitivity 4 Increase the client's fluid intake for the next 12 hours

1 Recognize that this is an expected response Expecting this response after the diversion response is expected because mucus continually is secreted by the intestinal mucosa. Reporting this to the health care provider immediately is not necessary; mucus is expected with an ileal conduit

A nurse is caring for a client who just had surgery to repair an inguinal hernia. To limit a common complication associated with this surgery, the nurse should: 1 Apply an abdominal binder 2 Place a support under the scrotum 3 Teach the client to cough several times an hour 4 Encourage the client to eat a high carbohydrate diet

2 Place a support under the scrotum After inguinal hernia repair, the scrotum commonly becomes edematous and painful; drainage is facilitated by elevating the scrotum on rolled linen or using a scrotal support

The nurse provides education to a client about the side effects of furosemide (Lasix). Which client statements indicate that the teaching is understood? (Select all that apply.) 1 "I must not eat citrus fruits." 2 "I should wear dark glasses." 3 "I should avoid lying flat in bed." 4 "I should change my position slowly." 5 "I must eat a food that contains potassium every day."

4 "I should change my position slowly." 5 "I must eat a food that contains potassium every day."

Which action should be included in the plan of care for a client who has had pelvic surgery? 1 Encouraging the client to ambulate in the hallway. 2 Elevating the client's legs by raising the bed's knee support. 3 Assisting the client to dangle the legs over the side of the bed. 4 Maintaining the client on bed rest until the bandages are removed.

1 Encouraging the client to ambulate in the hallway. Muscle contractions during ambulation improves venous return, preventing venous stasis and thrombus formation.

A client who has had a transurethral prostatectomy (TURP) experiences dribbling after the indwelling catheter is removed. To address this problem, an appropriate nursing response is: 1 "Increase your fluid intake and urinate at regular intervals." 2 "I know you're worried, but it will go away in a few days." 3 "Limit your fluid intake and urinate when you first feel the urge." 4 "The catheter will have to be reinserted until your bladder regains its tone."

1 "Increase your fluid intake and urinate at regular intervals." Increasing fluid intake and urinating at regular intervals will improve bladder tone, which should alleviate dribbling.

A nurse is caring for a client who had a nephrectomy because of cancer of the kidney. Which factor will influence the client's ability to deep breathe and cough postoperatively? 1 Location of the surgical incision 2 Increased anxiety about the prognosis 3 Inflammatory process associated with surgery 4 Pulmonary congestion from preoperative medications

1 Location of the surgical incision

A client arrives at a health clinic reporting hematuria, frequency, urgency, and pain on urination. What does the nurse suspect is the cause of these signs and symptoms? 1 Chronic glomerulonephritis 2 Cystitis 3 Nephrotic syndrome 4 Pyelonephritis

2 Cystitis Cystitis is an inflammation of the bladder that causes frequency and urgency of urination, pain on micturition, and hematuria. Chronic glomerulonephritis is atrophy of the kidney that is associated with manifestations of systemic circulatory overload. Nephrotic syndrome is a condition of increased glomerular permeability characterized by severe proteinuria. Pyelonephritis is a diffuse, pyogenic infection of the pelvis and parenchyma of the kidney that causes flank pain, chills, fever, and weakness.

After prostate surgery a client's indwelling catheter and continuous bladder irrigation (CBI) are to be removed. The nurse discusses the procedure with the client. The nurse evaluates that the teaching is understood when the client states, "After the catheter is removed I probably will: 1 Have dilute urine." 2 Be unable to urinate." 3 Produce dark red urine." 4 Experience some burning on urination."

4 Experience some burning on urination." Because of the trauma to the mucous membranes of the urinary tract, burning on urination is an expected response that should subside gradually. The urine should no longer be dilute after the continuous bladder irrigation is discontinued and removed. However, the urine may have a slight pink tinge because of the trauma from the surgery and the presence of the catheter. An inability to urinate should not occur unless the indwelling catheter is removed too soon and there is still edema of the urethra. Production of dark red urine is a sign of hemorrhage, which should not occur.

A nurse is caring for a client with glomerulonephritis. What should the nurse instruct the client to do to prevent recurrent attacks? 1 Take showers instead of tub baths. 2 Continue the same restrictions on fluid intake. 3 Avoid situations that involve physical activity. 4 Seek early treatment for respiratory tract infections.

4 Seek early treatment for respiratory tract infections. Hemolytic streptococci, common in throat infections, can initiate an immune reaction that damages the glomeruli.

A client is scheduled for an intravenous pyelogram (IVP). The nurse explains that on the day before the IVP the client must: 1 Avoid fats and proteins 2 Drink a large amount of fluids 3 Omit dinner and limit beverages 4 Take a laxative before going to bed

4 Take a laxative before going to bed Laxatives remove feces and flatus, providing better visualization.

A client has a kidney transplant. The nurse should monitor for which signs associated with rejection of the transplant? (Select all that apply.) 1 Fever 2 Oliguria 3 Jaundice 4 Moon face 5 Weight gain

1 Fever 2 Oliguria 5 Weight gain Fever is a characteristic of the systemic inflammatory response to the antigen (transplanted kidney). Oliguria (100 to 400 mL daily) or anuria (less than 100 mL daily) occurs when the transplanted kidney is rejected and fails to function. Weight gain can occur from fluid retention when the transplanted kidney fails to function or as a result of steroid therapy. This response must be assessed further. Jaundice is unrelated to rejection. Moon face is a side effect of steroid therapy; it is not a sign of rejection.

A client is admitted to the hospital from the emergency department with a diagnosis of urolithiasis. The nurse reviews the client's clinical record and performs an admission assessment. What is the priority nursing action? 1 Strain the client's urine. 2 Administer the prescribed morphine. 3 Place in the high-Fowler position. 4 Collect a urine specimen for culture and sensitivity

2 Administer the prescribed morphine. Pain relief is the priority. Clients report that ureteral colic is excruciatingly painful. Once pain is under control and the client is comfortable, other medical and nursing interventions can be implemented. Although straining all urine is required, pain relief is the priority. Once the client is medicated for pain, the urine that was set aside can be strained. The high-Fowler position is not necessary. The client can be assisted to assume a position of comfort. The urine was sent for a culture and sensitivity in the emergency department.

A client who had a transurethral resection of the prostate is transferred to the post-anesthesia care unit with an IV and a urinary retention catheter. For which major complication is it most important for the nurse to assess during the immediate postoperative period? 1 Sepsis 2 Hemorrhage 3 Leakage around the catheter 4 Urinary retention with overflow

2 Hemorrhage After transurethral surgery, hemorrhage is common because of venous oozing and bleeding from many small arteries in the area. Sepsis is unusual, and if it occurs it will manifest later in the postoperative course.

A nurse is caring for a client with a diagnosis of chronic kidney failure who has just been told by the health care provider that hemodialysis is necessary. Which clinical manifestation indicates the need for hemodialysis? 1 Ascites 2 Acidosis 3 Hypertension 4 Hyperkalemia

4 Hyperkalemia Protein breakdown liberates cellular potassium ions, leading to hyperkalemia, which can cause a cardiac dysrhythmia and standstill. The failure of the kidneys to maintain a balance of potassium is one of the main indications for dialysis. Ascites occurs in liver disease and is not an indication for dialysis. Dialysis is not the usual treatment for acidosis; usually this responds to administration of alkaline drugs. Dialysis is not a treatment for hypertension; this is usually controlled by antihypertensive medication and diet.

A nurse is assessing a client who is scheduled for a liver biopsy. What assessment finding needs to be reported immediately because it warrants a postponement of the liver biopsy? 1 Mental confusion 2 International normalized ratio (INR) of 4.0 3 Presence of an infectious disease 4 Foods high in vitamin K eaten before the biops

2 International normalized ratio (INR) of 4.0 Prolonged INR time indicates that the client has a deficiency in clotting; this should be corrected before the biopsy is performed to prevent hemorrhag

A male client reports dysuria, nocturia, and difficulty starting the urinary stream. A cystoscopy and biopsy of the prostate gland have been scheduled. After the procedure the client reports an inability to void. The nurse should: 1 Limit oral fluids until the client voids 2 Assure the client that this is expected 3 Insert a urinary retention catheter 4 Palpate above the pubic symphysis

4 Palpate above the pubic symphysis A full bladder is palpable with urinary retention and distention, which are common problems after a cystoscopy because of urethral edema.

During discharge teaching, a client with an ileal conduit asks how frequently the urine pouch should be emptied. The best reply by the nurse is: 1 "To prevent leakage and pulling of the pouch from the skin, it should be emptied every few hours." 2 "To prevent skin irritation, it should be emptied every hour if any urine has collected in the bag." 3 "To reduce the risk of infection, the system should be opened as little as possible; two times a day is adequate." 4 "To reduce the cost of drainage pouches, it should be emptied once the system is switched to a bedside collection bag."

1 "To prevent leakage and pulling of the pouch from the skin, it should be emptied every few hours."

A client with acute kidney failure is to receive peritoneal dialysis and asks why the procedure is necessary. The nurse's best response is, "It: 1 Prevents the development of serious heart problems." 2 Helps perform some of the work usually done by the kidneys." 3 Removes toxic chemicals from the body so you will not get worse." 4 Speeds recovery because the kidneys are not responding to other therapy."

2 Helps perform some of the work usually done by the kidneys." Dialysis removes chemicals, wastes, and fluids usually removed from the body by the kidneys. The mention of heart problems is a threatening response and may cause increased fear or anxiety. Stating that peritoneal dialysis "removes toxic chemicals from the body so you will not get worse" is threatening and can cause an increase in anxiety. Dialysis helps maintain fluid and electrolyte balance; there are no data to indicate the cause of the acute kidney failure or previous therapy.

The nurse provides discharge instructions to a male client that had a ureterolithotomy. The client has a history of recurrent urinary tract infections (UTIs). The teaching should include that indicators of a UTI are: 1 Urgency or frequency of urination 2 The inability to maintain an erection 3 Pain radiating to the external genitalia 4 An increase in the alkalinity of the urine

1 Urgency or frequency of urination

After a nephrectomy a client arrives in the post-anesthesia care unit in the supine position. Which action should be employed by the nurse to assess the client for signs of hemorrhage? 1 Turn the client to observe the dressings. 2 Press the client's nail beds to assess capillary refill. 3 Observe the client for hemoptysis when suctioning. 4 Monitor the client's blood pressure for a rapid increase

1 Turn the client to observe the dressings.

A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which responses? (Select all that apply.) 1 Weight loss 2 Negative nitrogen balance 3 Increased urine specific gravity 4 Excessive loss of potassium ions 5 Pronounced retention of sodium ions

1 Weight loss 4 Excessive loss of potassium ions

A client who has been on hemodialysis for several weeks asks the nurse what substances are being removed by the dialysis. The nurse informs the client that one of the substances passing through the membrane is: 1 Blood 2 Sodium 3 Glucose 4 Bacteria

2 Sodium Sodium is an electrolyte that passes through the semipermeable membrane during hemodialysis. Red blood cells do not pass through the semipermeable membrane during hemodialysis. Glucose does not pass through the semipermeable membrane during hemodialysis. Bacteria do not pass through the semipermeable membrane during hemodialysis.

A client is suspected of having late-stage (tertiary) syphilis. When obtaining a health history, the nurse determines that the client statement that most supports this diagnosis is: 1 "I noticed a wart on my penis." 2 "I have sores all over my mouth." 3 "I've been losing a lot of hair lately." 4 "I'm having trouble keeping my balance."

4 "I'm having trouble keeping my balance." Neurotoxicity, as manifested by ataxia, is evidence of tertiary syphilis, which may involve the central nervous system (CNS); other CNS signs include confusion, paralysis, delusions, impaired judgment, and slurred speech. A sore on the penis occurs in the secondary stage. Sores in the mouth occur in the secondary stage. Alopecia is not a sign of late-stage syphilis.

What should a nurse do when caring for a client with continuous bladder irrigation? 1 Measure the output hourly. 2 Monitor the specific gravity of the urine. 3 Irrigate the catheter with saline three times daily. 4 Subtract the amount of irrigant instilled from the output.

4 Subtract the amount of irrigant instilled from the output. The amount of irrigant instilled must be deducted from the total output to determine the amount of urine voided.

A male client has discharge from his penis. Gonorrhea is suspected. To obtain a specimen for a culture, the nurse should: 1 Instruct the client to provide a semen specimen 2 Swab the discharge when it appears on the prepuce 3 Teach the client how to obtain a clean catch specimen of urine 4 Swab the drainage directly from the urethra to obtain a specimen

4 Swab the drainage directly from the urethra to obtain a specimen Swabbing the drainage directly from the urethra obtains a specimen uncontaminated by environmental organisms.

A client with the diagnosis of chronic kidney disease develops hypocalcemia. Which clinical manifestations should the nurse expect the client with hypocalcemia to exhibit? (Select all that apply.) 1 Acidosis 2 Lethargy 3 Bone pain 4 Chvostek sign 5 Muscle cramps

4 Muscle twitching 5 Respiratory acidosis Chvostek sign is elicited by tapping the face in front of the ear over the facial nerve; a positive sign is evidence of tetany and is caused by decreased serum calcium. Muscle cramps result from decreased serum calcium; functions of calcium include muscle contraction and transmission of nerve impulses.

The nurse is providing dietary teaching to a 40-year-old client who is receiving hemodialysis. The nurse should encourage the client to include what in the client's dietary plan? 1 Rice 2 Potatoes 3 Canned salmon 4 Barbecued beef

1 Rice Foods high in carbohydrates and low in protein, sodium, and potassium are encouraged for these clients.

The nurse is caring for a client with acute renal failure. The most serious complication for this client is: 1 Anemia 2 Infection 3 Weight loss 4 Platelet dysfunction

2 Infection Infection is responsible for one third of the traumatic or surgically induced deaths of clients with acute renal failure, as well as for medically induced acute renal failure.

A client with acute kidney failure becomes confused and irritable. Which does the nurse determine is the most likely cause of this behavior? 1 Hyperkalemia 2 Hypernatremia 3 A limited fluid intake 4 An increased blood urea nitrogen level

4 An increased blood urea nitrogen level

A health care provider prescribes furosemide (Lasix) for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in what part of the renal system? 1 Distal tubule 2 Collecting duct 3 Glomerulus of the nephron 4 Loop of Henle

4 Loop of Henle

A client with acute renal failure moves into the diuretic phase after one week of therapy. For which signs during this phase should the nurse assess the client? (Select all that apply.) 1 Dehydration 2 Hypovolemia 3 Hyperkalemia 4 Metabolic acidosis 5 Skin rash

1 Dehydration 2 Hypovolemia In the diuretic phase, fluid retained during the oliguric phase is excreted and may reach 3 to 5 L daily; dehydration will occur unless fluids are replaced. In the diuretic phase, fluid retained during the oliguric phase is excreted and may reach 3 to 5 L daily; hypovolemia may occur, and fluids should be replaced.

A client with chronic kidney disease has been on hemodialysis for two years. The client relates to a nurse in the dialysis unit in an angry, critical manner and frequently does not follow the prescribed diet or take prescribed medications. What does the nurse identify as the most likely underlying cause of this behavior? 1 A constructive method of accepting reality 2 A defense against underlying depression and fear 3 An attempt to punish the nurse and the members of the staff 4 An effort to maintain the previous lifestyle as much as possible

2 A defense against underlying depression and fear

A client's urine specific gravity is being measured. For what condition should the nurse conduct a focused assessment when a client's specific gravity is increased? 1 Fluid overload 2 Low-grade fever 3 Diabetes insipidus 4 Chronic kidney disease

2 Low-grade fever An elevated temperature can lead to dehydration and an increased urine specific gravity (more than 102.5). When there is edema or fluid overload, the accumulating body fluid will cause a decrease in the specific gravity of the urine

A client with an ileal conduit is being prepared for discharge. As part of the discharge teaching, the nurse instructs the client to: 1 Abstain from beer and alcohol consumption 2 Maintain fluid intake of at least 2 L daily 3 Notify the health care provider if the stoma size decreases 4 Avoid getting soap and water on the peristomal skin

2 Maintain fluid intake of at least 2 L daily High-fluid intake flushes the ileal conduit and prevents infection and obstruction caused by mucus or uric acid crystals

A client with a urinary retention catheter reports discomfort in the bladder and urethra. What should the nurse do first? 1 Milk the tubing gently. 2 Notify the health care provider. 3 Check the patency of the catheter. 4 Irrigate the catheter with prescribed solutions

2 Notify the health care provider.

A nurse is caring for a client who has a radium implant for cancer of the cervix. What is the priority nursing intervention? 1 Store urine in lead-lined containers. 2 Restrict visitors to a 10-minute stay. 3 Wear a lead-lined apron when giving care. 4 Avoid giving injections in the gluteal muscle.

2 Restrict visitors to a 10-minute stay.

A client admitted to the hospital in the oliguric phase of acute renal failure estimates that the urine output for the last 12 hours was less than 240 mL. The nurse reviews the plan of care and notes a prescription for 900 mL of water to be given orally over the next 24 hours. The nurse concludes that this amount of fluid was prescribed to: 1 Equal the expected urinary output for the next 24 hours 2 Prevent the development of hypostatic pneumonia and fever 3 Compensate for both insensible and expected output over the next 24 hours 4 Prevent hyperkalemia, which can lead to life-threatening cardiac dysrhythmias

3 Compensate for both insensible and expected output over the next 24 hours Insensible losses are 400 to 500 mL in 24 hours; the measured output is about 400 mL in 24 hours based on the available history

Before a client with syphilis can be treated, what should be determined? 1 Portal of entry 2 Size of chancre 3 Existence of allergies 4 Names of sexual contacts

3 Existence of allergies Although the treatment of choice is penicillin, clients who are allergic must be given other antimicrobial agents to avoid an anaphylactic reaction

A nurse is monitoring a client with renal failure for signs of fluid excess. Which finding does the nurse identify as inconsistent with fluid excess? 1 Increased weight 2 Distended neck veins 3 Orthostatic hypotension 4 Abnormal breath sounds

3 Orthostatic hypotension

During the postoperative period after surgery for a kidney transplant, the client's creatinine level is 3.1 mg/dL. What should the nurse do first in response to this laboratory result? 1 Notify the health care provider. 2 Check the intravenous (IV) infusion. 3 Obtain current blood test results. 4 Assess for decreased urine output.

4 Assess for decreased urine output. The expected serum creatinine range is 0.5 to 1.2 mg/dL. The nurse should obtain additional information that may indicate acute rejection; therefore, the nurse must first assess for decreased urine output and changes in vital signs. Once additional data are collected (e.g., urine output, current blood work reports) and the IV infusions are checked, the nurse should contact the health care provider, explain the situation, and implement further prescriptions. Eventually the nurse should ensure that proper infusion rates, along with IV medications, are being maintained after the client is first assessed for decreased urine output and for changes in vital signs. Current blood work reports should be obtained after the client is assessed for decreased urine output and changes in vital signs.

A client just had a suprapubic prostatectomy. Which action should the nurse implement to prevent a secondary bladder infection? 1 Observe for signs of uremia 2 Attach the catheter to suction 3 Clamp off the connecting tube 4 Change the dressings frequently

4 Change the dressings frequently After a suprapubic prostatectomy, leakage of urine generally is identified around the suprapubic tube; this creates an environment in which bacteria can flourish if the dressing is not changed frequently

Which clinical manifestation should a nurse expect a client with diabetes insipidus to exhibit? 1 Increased blood glucose 2 Decreased serum sodium 3 Increased specific gravity 4 Decreased urine osmolarity

4 Decreased urine osmolarity Insufficient antidiuretic hormone (ADH) decreases water uptake by the kidney tubules, resulting in very dilute urine with low osmolarity. Diabetes insipidus does not affect glucose levels. Serum sodium levels increase because of hemoconcentration. Specific gravity decreases with dilute urine.

After a successful kidney transplant for a client with end-stage kidney disease, the nurse anticipates that laboratory studies will demonstrate: 1 Increased specific gravity 2 Correction of hypotension 3 Elevated serum potassium 4 Decreasing serum creatinine

4 Decreasing serum creatinine As the transplanted organ functions, nitrogenous wastes are eliminated, lowering the serum creatinine. As more urine is produced by the transplanted kidney, the specific gravity and concentration of the urine will decrease.

Which clinical manifestations does a nurse expect that a client with renal calculi might report? (Select all that apply.) 1 Blood in the urine 2 Irritability and twitching 3 Dry, itchy skin and pyuria 4 Frequency and urgency of urination 5 Pain radiating from the kidney to a shoulder

1 Blood in the urine 4 Frequency and urgency of urination Hematuria is a common clinical manifestation of renal calculi. Frequency and a sense of urgency may occur because of irritation caused by the calculi; the most common expectation is sharp, severe pain.

A nurse is developing a discharge plan for a client who was hospitalized with severe cirrhosis of the liver. The plan should include the: 1 Need for a high protein diet 2 Use of a sedative for relaxation 3 Need to increase fluids 4 Importance of reporting personality changes to the health care provider

4 Importance of reporting personality changes to the health care provider The damaged liver may cause increased ammonia levels, resulting in central nervous system (CNS) irritation, which produces behavioral changes. A damaged liver does not metabolize protein adequately; a low protein diet is indicated.

Which statement regarding treatment with interferon indicates that the client understands the nurse's teaching? 1 "I will drink two to three quarts of fluid a day." 2 "Any reconstituted solution must be discarded in one week." 3 "I can continue driving my car as long as I have the stamina." 4 "While taking this medicine I should be able to continue my usual activity."

1 "I will drink two to three quarts of fluid a day." Adequate fluid intake helps to flush the kidneys and prevent nephrotoxicity, especially during the early phase of treatment. Reconstituted solution may be stored in the refrigerator for one month. Confusion, dizziness, and hallucinations are side effects of this drug; the client should avoid hazardous tasks, such as driving or using machinery. Activity may have to be altered because fatigue and other flu-like symptoms are common with this drug.

A client who is suspected of having Cushing syndrome is admitted to the hospital. The nurse plans to monitor this client for: 1 Hypokalemia 2 Hypovolemia 3 Hypocalcemia 4 Hyponatremia

1 Hypokalemia With glucocorticoid excess, aldosterone hypersecretion occurs and sodium is retained; therefore, potassium is excreted, leading to hypokalemia

A nurse is caring for a client who reports urinary problems, and the health care provider prescribes a cholinergic medication. Which response is prevented that helps the nurse determine that the medication is effective? 1 Bladder spasticity 2 Bladder flaccidity 3 Urinary tract calculi 4 Urinary tract infections

2 Bladder flaccidity Cholinergics intensify and prolong the action of acetylcholine, which increases tone in the genitourinary tract, preventing urinary retention. Anticholinergics are prescribed for frequency and urgency associated with a spastic bladder. Cholinergics will not prevent renal calculi. Urinary tract infections are a secondary gain because cholinergics help prevent urinary retention that can lead to urinary tract infection, but this is not the primary purpose for administering a cholinergic.

A nurse is providing postoperative care to a client who had a kidney transplant. What assessment is the best indicator of the functioning of the newly transplanted kidney? 1 Renal scan 2 Serum creatinine 3 White blood cell (WBC) count 4 Intake and output balance daily

2 Serum creatinine Serum creatinine, a test of renal function, measures the kidneys' ability to excrete metabolic wastes; creatinine, a nitrogenous product of protein breakdown, is increased with kidney insufficiency.

A nurse is providing preoperative teaching for a client who is scheduled for a transurethral resection of the prostate. What should the nurse include in the client's postoperative teaching plan? 1 The urine will be bright red for 24 to 48 hours 2 Spasms of the bladder occur during the first 24 to 48 hours 3 To decrease bladder contractions, the Valsalva maneuver and Kegel exercises will be encouraged 4 To maintain proper fluid balance, oral fluids are restricted during continuous urinary bladder irrigations

2 Spasms of the bladder occur during the first 24 to 48 hours Spasms result from irritation of the bladder during surgery; they decrease in intensity and frequency as healing occurs. Urine that is bright red for 24 to 48 hours is too long; this indicates hemorrhage. Drainage should be dark red and after the first few hours gradually turn pink. The Valsalva maneuver should be avoided because it may initiate prostatic bleeding, not bladder contractions. The presence of continuous bladder irrigation (CBI) is unrelated to the amount of oral fluids that should be consumed; once the continuous bladder irrigation is discontinued, oral fluids should be encouraged.

A nurse is caring for a client with chronic kidney failure. Which clinical findings should the nurse expect when assessing this client? (Select all that apply.) 1 Polyuria 2 Lethargy 3 Hypotension 4 Muscle twitching 5 Respiratory acidosis

2 Lethargy 4 Muscle twitching Lethargy results from anemia, buildup of urea, and vitamin deficiencies. Muscle twitching results from excess nitrogenous wastes.

A nurse is caring for a client with end-stage renal disease. Which clinical indicators of end-stage renal disease should the nurse expect? (Select all that apply.) 1 Polyuria 2 Jaundice 3 Azotemia 4 Hypertension 5 Polycythemia

3 Azotemia 4 Hypertension Azotemia is an increase in nitrogenous waste, particularly urea, in the blood; this is common in end-stage renal disease. Hypertension occurs as a result of fluid and sodium overload and dysfunction of the rennin-angiotensin-aldosterone system. Excessive nephron damage in end-stage renal disease causes oliguria, not polyuria; excessive urination is common in early kidney insufficiency from an inability to concentrate urine. Jaundice is common with biliary obstruction, not end-stage renal disease. Anemia, not polycythemia, occurs because of decreased erythropoietin, decreased red blood cell (RBC) production, and decreased RBC survival time.

After a nephrectomy a client arrives in the post-anesthesia care unit in the supine position. Which action should be employed by the nurse to assess the client for signs of hemorrhage? 1 Turn the client to observe the dressings. 2 Press the client's nail beds to assess capillary refill. 3 Observe the client for hemoptysis when suctioning. 4 Monitor the client's blood pressure for a rapid increase.

1 Turn the client to observe the dressings. Because of the anatomic position of the incision, drainage will flow by gravity and accumulate under the client lying in the supine position.

A nurse is evaluating a client's response to fluid replacement therapy. Which clinical finding indicates adequate tissue perfusion to vital organs? 1 Urinary output of 30 mL in an hour 2 Central venous pressure reading of 2 mm Hg 3 Baseline pulse rate of 120 that decreases to 110 beats/min within a 15-minute period 4 Baseline blood pressure of 50/30 that increases to 70/40 mm Hg within a 30-minute period

1 Urinary output of 30 mL in an hour A urinary output rate of 30 mL/hour is considered adequate for perfusion of the kidneys, heart, and brain.

An older adult client is demonstrating mild confusion after surgical repair of a hernia. What should the nurse do to provide for this client's safety? 1 Use a nightlight in the client's room. 2 Secure a prescription for a soft vest restraint. 3 Activate the position-sensitive bed alarm. 4 Raise the four side rails on the client's bed.

3 Activate the position-sensitive bed alarm.

When admitting a client with benign prostatic hyperplasia, the most relevant assessment made by the nurse is: 1 Perineal edema 2 Urethral discharge 3 Flank pain radiating to the groin 4 Distention of the suprapubic area

4 Distention of the suprapubic area

A client is diagnosed as having kidney failure. During the oliguric phase the nurse should assess the client for: 1 Hyperkalemia 2 Hypocalcemia 3 Hypernatremia 4 Hypoproteinemia

1 Hyperkalemia The kidneys retain potassium during the oliguric phase of kidney failure; an elevated potassium level is one of the main indicators of the need for dialysis. Hypercalcemia occurs, not hypocalcemia. Hyponatremia occurs, not hypernatremia. Hyperproteinemia occurs, not hypoproteinemia.

A client has surgery to repair a bladder laceration. The nursing intervention that takes priority in the postoperative care of this client is: 1 Repositioning frequently 2 Giving lower back care 3 Implementing range-of-motion (ROM) exercises 4 Providing teaching related to incision care

1 Repositioning frequently

A client with end-stage renal disease is hospitalized. For what signs and symptoms of complications should the nurse monitor the client? (Select all that apply.) 1 Anemia 2 Dyspnea 3 Jaundice 4 Anasarca 5 Hyperexcitability

1 Anemia 2 Dyspnea 4 Anasarca

A nurse is caring for a client with end-stage renal disease who has a mature arteriovenous (AV) fistula. What nursing care should be included in the client's plan of care? (Select all that apply.) 1 Auscultate for a bruit. 2 Palpate the site to identify a thrill. 3 Irrigate with saline to maintain patency. 4 Avoid drawing blood from the affected extremity. 5 Keep the fistula clamped until ready to perform dialysis.

1 Auscultate for a bruit. 2 Palpate the site to identify a thrill. 4 Avoid drawing blood from the affected extremity.

A client with a history of chronic kidney disease is hospitalized. The nurse assesses the client for signs of related kidney insufficiency, which include: 1 Facial flushing 2 Edema and pruritus 3 Dribbling after voiding 4 Diminished force and caliber of stream

2 Edema and pruritus

The nurse reviews a client's medication history, which includes a cholinergic medication. The client states, "I take that for some kind of urinary problem." The nurse recalls that cholinergic medications are prescribed primarily for what type of urinary condition? 1 Kidney stones 2 Flaccid bladder 3 Spastic bladder 4 Urinary tract infections

2 Flaccid bladder Cholinergics intensify and prolong the action of acetylcholine, which increases the tone in the genitourinary tract, preventing urinary retention.

An acute, life-threatening complication for which a nurse should assess a client in the early postoperative period after a radical nephrectomy is: 1 Sepsis 2 Hemorrhage 3 Renal failure 4 Paralytic ileus

2 Hemorrhage The kidney, an extremely vascular organ, receives a large percentage of the blood flow, and hemorrhage from the operative site can occur. Sepsis and renal failure may occur later in the postoperative period. Paralytic ileus can occur, but it is not life threatening.

A client is admitted to the hospital with a diagnosis of chronic kidney disease. Which responses should the nurse expect the client to exhibit? (Select all that apply.) 1 Polyuria 2 Paresthesias 3 Hypertension 4 Metabolic alkalosis 5 Widening pulse pressure

2 Paresthesias 3 Hypertension Paresthesias occur as a result of excess nitrogenous wastes, altered fluid and electrolyte balance, and altered regulatory functions. Nonfunctioning kidneys cause fluid retention that may result in hypervolemia and hypertension.

A nurse teaches the signs of organ rejection to a client who had a kidney transplant. What should be included in the education? 1 Weight loss 2 Subnormal temperature 3 Elevated blood pressure 4 Increased urinary output

3 Elevated blood pressure Hypertension is caused by hypervolemia because of the failure of the new kidney. Weight gain, not loss, occurs with a rejection of the kidney because of fluid retention. The client will have an elevated temperature exceeding 100° F with kidney rejection. Urine output will be decreased or absent, depending on the degree of kidney rejection.

What does the nurse determine is the most likely cause of renal calculi in clients with paraplegia? 1 High fluid intake 2 Increased intake of calcium 3 Inadequate kidney function 4 Accelerated bone demineralization

4 Accelerated bone demineralization Calcium that has left the bones as a response to prolonged inactivity enters the blood and may precipitate in the kidneys, forming calculi.

An older client who is living in a nursing home is admitted to the hospital to be treated with intravenous antibiotics for sepsis resulting from a urinary tract infection. The client becomes agitated and attempts to pull out the IV. The health care provider prescribes a stat dose of haloperidol (Haldol) 0.5 mg IM. The haloperidol is available in a vial that states there are 2 mg/mL. How much solution should the nurse administer? Include a leading zero if applicable. Record your answer using two decimal places. __________ mL

Solve the problem by using ratio and proportion. Desire 0.5 mg x mL ------------- = ---- Have 2 mg 1 mL 2x = 0.5 x = 0.5 ÷ 2 x = 0.25 mL

An older adult client states, "I walk 2 miles a day for exercise, but now that the weather is hot, I am worried about becoming dehydrated." What should the nurse teach the client? 1 Drink fruit juices if you start to feel dehydrated. 2 Thirst is a good guide to use to determine fluid intake. 3 Fluids should be increased if the urine is getting darker. 4 Water should be consumed when the skin becomes dry

3 Fluids should be increased if the urine is getting darker.

To help prevent a cycle of recurring urinary tract infections, the nurse should plan to instruct a female client to: 1 Increase the daily intake of citrus juice 2 Douche regularly with alkaline agents 3 Urinate as soon as possible after intercourse 4 Wipe carefully from back to front

3 Urinate as soon as possible after intercourse

The nurse should ask the client with secondary syphilis about sexual contacts during the past: 1 21 days 2 30 days 3 Three months 4 Six months

4 Six months The client is in the secondary stage, which begins from six weeks to six months after primary contact; therefore, a six-month history is needed to ensure that all possible contacts are located. Any time less than six months may miss contacts that may have become infected.

When receiving hemodialysis, the complication of the removal of too much sodium may occur. For which clinical findings associated with hyponatremia should the nurse assess the client? (Select all that apply.) 1 Chvostek sign 2 Muscle cramps 3 Extreme fatigue 4 Cardiac dysrhythmias 5 Increased temperature

2 Muscle cramps 3 Extreme fatigue Sodium is the most abundant cation in the extracellular fluid and functions as part of the sodium/potassium pump. In the presence of a deficit, the client will exhibit confusion, lethargy, headache, and muscle cramps. Lethargy results in the presence of a deficit. Spasm of the facial muscles following a tap over the facial nerve (Chvostek sign) indicates hypocalcemia. Cardiac dysrhythmias are associated with increases or decreases in potassium and calcium. An increase in body temperature reflects a possible infection, not an electrolyte imbalance.

The nurse is caring for a client with a diagnosis of acute kidney failure associated with drug toxicity. When the client complains of thirst, the nurse should offer: 1 Ice chips 2 Warm milk 3 Hard candy 4 Carbonated soda

3 Hard candy Sucking on candy will relieve thirst and provide calories without supplying extra fluid. Ice chips add to the restricted fluid intake. Milk contains both fluids and proteins, which should be restricted with acute kidney failure. Carbonated beverages may be high in sodium and provide additional fluid; both should be restricted.

Which is the most serious complication for which the nurse must monitor a client with kidney failure? 1 Anemia 2 Weight loss 3 Hyperkalemia 4 Platelet dysfunction

3 Hyperkalemia

A client who has repeated episodes of cystitis is scheduled for a cystoscopy to determine the possibility of urinary tract abnormalities. The client asks the nurse to describe the procedure. The nurse's most appropriate response is, "This procedure is: 1 A computerized scan that outlines the bladder and surrounding tissue." 2 An x-ray film of the abdomen, kidneys, ureters, and bladder after administration of dye." 3 The visualization of the inside of the bladder with an instrument connected to a source of light." 4 The visualization of the urinary tract through ureteral catheterization and the use of radiopaque material."

3 The visualization of the inside of the bladder with an instrument connected to a source of light."

A client with chronic kidney disease is admitted to the hospital with severe infection and anemia. The client is depressed and irritable. The client's spouse asks the nurse about the anticipated plan of care. What is an appropriate nursing response? 1 "The staff will provide total care because the infection causes severe fatigue." 2 "Mood elevators will be prescribed to improve depression and irritability." 3 "Iron will be prescribed for the anemia and the stools will be dark." 4 "The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."

4 "The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."

A client experiences difficulty in voiding after an indwelling urinary catheter is removed. The nurse determines that this difficulty most likely is related to: 1 Fluid imbalance 2 Sedentary lifestyle 3 Interruption in previous voiding habits 4 Nervous tension following the procedure

3 Interruption in previous voiding habits An indwelling catheter dilates the urinary sphincters, keeps the bladder empty, and short-circuits the reflex mechanism based on bladder distention. When the catheter is removed, the body must adapt to functioning once again.

A client comes to the emergency department because of minimal urinary output despite drinking adequate fluid. The client's blood pressure is 190/94. For what additional clinical manifestation associated with this data, should the nurse assess the client? 1 Thirst 2 Urinary retention 3 Weight gain 4 Urinary hesitancy

3 Weight gain Oliguria is the inability to produce more than 400 to 500 mL of urine daily. Expected daily urinary output is 1000 to 3000 mL daily, depending on the volume of fluid intake. If urine is not being produced in the presence of an average daily intake, fluid will be retained and reflected in weight gain. One liter of fluid weighs 2.2 pound

A nurse is caring for a client with complications associated with peritoneal dialysis. For which signs and symptoms should the nurse monitor the client? (Select all that apply.) 1 Pruritus 2 Oliguria 3 Tachycardia 4 Cloudy outflow 5 Abdominal pain

3 Tachycardia 4 Cloudy outflow 5 Abdominal pain An increase in vital signs, including tachycardia, is associated with peritonitis, a complication of peritoneal dialysis . Cloudy outflow is associated with peritonitis; the presence of purulent material and red blood cells makes the outflow appear cloudy. Abdominal pain is a sign of peritonitis. Pruritus is a result of impaired renal function, not of peritoneal dialysis. Oliguria is a result of end-stage renal disease, not peritoneal dialysis.

A client is diagnosed with calcium oxalate renal calculi. Which nutrients should the nurse teach the client to avoid? (Select all that apply.) 1 Milk 2 Nuts 3 Liver 4 Spinach 5 Rhubarb

2 Nuts 4 Spinach 5 Rhubarb Nuts, especially peanuts, almonds, and pecans, should be avoided. Clients with struvite stones (staghorn stones) also should avoid nuts. Rhubarb and spinach are high in calcium oxalate. Other examples include beets, wheat bran, tea, chocolate, and coffee. Limiting oxalate-rich foods limits oxalate absorption and the formation of calcium oxalate calculi

A nurse plans to teach the signs of rejection to a client who just had a transplanted kidney. What sign of rejection should the nurse include? 1 Weight loss 2 Subnormal temperature 3 Elevated blood pressure 4 Increased urinary output

3 Elevated blood pressure Hypertension results from hypervolemia because of failure of the new kidney. Weight gain will occur because of fluid retention with failure of a transplanted kidney. Body temperature will exceed 100° F if a kidney is rejected. Urine output will be decreased or absent, depending on the degree of failure.

Despite receiving 2900 mL intake for two days, the client's urine output has progressively diminished. The nurse identifies that the urinary output is less than 40 mL/hr over the past three hours. What action should the nurse take? 1 Assess breath sounds and obtain vital signs 2 Decrease the intravenous (IV) flow rate and increase oral fluids 3 Insert an indwelling catheter to facilitate emptying of the bladder 4 Check for dependent edema by assessing the lower extremities

1 Assess breath sounds and obtain vital signs The imbalance in intake and output, with a decreasing urinary output, may indicate kidney failure. The retention of excess body fluid can precipitate the development of heart failure. Assessing breath sounds and obtaining the vital signs are necessary when monitoring for these complications.

A client will be taking nitrofurantoin (Macrobid) 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client? 1 Increase the intake of fluids. 2 Strain the urine for crystals and stones. 3 Stop the drug if urinary output increases. 4 Maintain the exact time schedule for taking the drug

1 Increase the intake of fluids.

The nurse is providing postoperative care eight hours after a client had a total cystectomy and the formation of an ileal conduit. What assessment finding should be reported immediately? 1 Edematous stoma 2 Dusky-colored stoma 3 Absence of bowel sounds 4 Pink-tinged urinary drainage

Dusky-colored stoma may denote a compromised blood supply to the stoma and impending necrosis. Edematous stoma and absence of bowel sounds are expected in the early postoperative period after this surgery. Pink-tinged urine may be present in the immediate postoperative period.

A nurse is caring for a client with a diagnosis of renal calculi secondary to hyperparathyroidism. Which type of diet should the nurse explore with the client when providing discharge information? 1 Low purine 2 Low calcium 3 High phosphorus 4 High alkaline ash

2 Low calcium Calcium and phosphorus are components of these stones; foods high in calcium and phosphorus should be avoided. Low purine and high alkaline ash diets are indicated for clients with gout. Foods high in phosphorus must be avoided.

Before a transurethral resection of the prostate (TURP), a client asks about what to expect postoperatively. The most appropriate response by the nurse is: 1 "You will have an abdominal incision and a dressing." 2 "Your urine will be pink and free of clots." 3 "There will be an incision between your scrotum and rectum." 4 "There will be an indwelling urinary catheter and a continuous bladder irrigation in place."

4 "There will be an indwelling urinary catheter and a continuous bladder irrigation in place." The presence of an indwelling urinary catheter and a continuous bladder irrigation are routine postoperative expectations after a TURP; they provide for hemostasis and urinary excretion. An abdominal incision and dressing are present with a suprapubic, not transurethral, prostatectomy. After a TURP the client initially can expect hematuria and some blood clots; the continuous bladder irrigation keeps the bladder free of clots and the catheter patent