Benign Prostatic Hyperplasia

The client who has had a transurethral resection of the prostate is complaining of bladder spasms. The HCP prescribed an opiate suppository, belladonna and opitate (B&O). Which interventions should the nurse implement when administering this medication? (Select all that apply) A. Obtain the correct dose of the medication B. Lubricate the suppository with K-Y jelly C. Wash hands and don nonsterile gloves D. Check the client's armband for allergies E. Ask the client to lie on the left side

A,B,C,D,E -B&O suppositories come in 15A (1/2 grain) and 16 A (1 grain) formulations. When obtaining the medication from the narcotic cabinet the nurse should obtain the correct dose for the client. B&O suppositories are used to reduce bladder spasms for clients who have had bladder surgery. -Lubricating the suppository decreases the pain for the client when inserting the suppository. -Adhering to Standard Precautions is always an appropriate nursing intervention when caring for the client. -The nurse should check the armband before opening the medication and preparing to administer it. -The large intestine/rectum lies on the left side of the body, so placing the client on the left side makes insertion easier and reduces the change of a ruptured bowel.

When caring for a client with a history of BPH, what should the nurse do? (Select all that apply) A. Provide privacy and time for the client to void B. Monitor intake and output C. Catheterize the client for postvoid residual urine D. Ask the client if he has urinary retention E. Test the urine for hematuria

A,B,D,E Because of the history of BPH, the nurse should provide privacy and time for the client to void. The nurse should also monitor intake and output, assess the client for urinary retention, and test the urine for hematuria.

A client is being discharged to home 3 days after a TURP. What should the nurse instruct the client to do? (Select all that apply) A. Drink at least 3000 mL water per day B. Increase calorie intake by eating six small meals a day C. Report bright red bleeding to the HCP D. Take deep breaths and cough every 2 hours E. Report a temperature over 99 F

A,C,E The nurse should instruct the client to drink a large amount of fluids to keep the urine clear. The urine should be almost without color. About 2 weeks after TURP, when desiccated tissue is sloughed out, a secondary hemorrhage could occur. The client should be instructed to call the surgeon or go the emergency department if at any time the urine turns bright red. The nurse should also instruct the client to report signs of infection such as a temperature over 99.

The male client diagnosed with complaints of urinary frequency and nocturia tells the nurse he is taking the herbal supplement saw palmetto. Which statement is the nurse's best response? A. "Use of saw palmetto is an old wives' tale" B. "This herb does help shrink the prostate tissue" C. "Have you noticed any itching or rashes?" D. "Saw palmetto has been known to cause cancer"

B Research has proved the efficacy of saw palmetto in treating BPH. The exact mechanism of action is unknown, but the herb does shrink prostate tissue, resulting in relief of urinary obstructive symptoms.

The nurse is caring for the client who is 24 hours post-TURP and is having painful bladder spasms. Which intervention should the nurse plan to implement? A. Give the prn prescribed morphine sulfate intravenously B. Give the prn prescribed belladonna and opium suppository C. Assist the client out of bed to ambulate in the hallway D. Apply warm and then a cold cloth to the client's abdomen

B The belladonna and opium suppository will inhibit smooth muscle contraction and decrease bladder spasms; thus, it will also reduce pain.

The primary reason for lubricating the urinary catheter generously before inserting the catheter into a male client is that this technique helps reduce: A. Spasms at the orifice of the bladder B. Friction along the urethra when the catheter is being inserted C. The number of organisms gaining entrance to the bladder D. The formation of encrustations that may occur at the end of the catheter.

B Liberal lubrication of the catheter before catheterization of a male reduces friction along the urethra and irritation and trauma to urethral tissues. Because the male urethra is tortuous, a liberal amount of lubrication is advised to ease catheter passage.

The client diagnosed with BPH has had a TURP. The client is complaining of lower abdominal pain. Which interventions should the nurse implement? (Rank in order of performance) A. Administer the prescribed morphine by slow IVP B. Check the urinary catheter for drainage and clots C. Determine if the client has a hard, rigid abdomin D. Adjust the saline irrigation to flush the bladder E. Dilute the morphine with several milliliters of normal saline

B-The most obvious reason for a client post-TURP to be having lower abdominal pain is that the bladder has blood clots that need to be flushed out. Clots that are not flushed from the bladder result in bladder spasms. Assessing the urinary drainage would be the first step. D-The next step is to adjust the rate of the irrigation to ensure adequate drainage of blood and clots from the bladder. C-Before administering a narcotic analgesic the nurse should rule out complication. Assessing for peritonitis (hard, rigid abdomen) is the next step in this situation. E-Morphine and most other narcotic medications require a very slow intravenous rate, around 5 minutes, according to the manufacturer's recommendations. The morphine is dispensed in 1 mL tubex syringes or vials. It is difficult to maintain a steady, slow administration of the medication with only 1 mL over 5 minutes. If the medication is diluted to a total volume of 10 mL, then the nurse can administer the medication at a rate of 1 mL every 30 seconds. Dilution causes less pain for the client and helps decrease irritation to the vein. A-The final step in this sequence is to actually administer the analgesic.

A client with BPH has an elevated prostate-specific antigen (PSA) level. The nurse should: A. Instruct the client to request having a colonoscopy before coming to conclusions about the PSA results B. Instruct the client that a urologist will monitor the PSA level biannually when elevated C. Determine if the prostatic palpitation was done before or after the blood sample was drawn D. Ask the client if he emptied his bladder before the blood sample was obtained

C Rectal and prostate examinations can increase serum PSA levels. The prostatic palpitation should be done after the blood sample is drawn.

A client with BPH is being treated with terazosin 2 mg at bedtime. The nurse should monitor the client's: A. Urine nitrites B. White blood cell count C. Blood pressure D. Pulse

C Terazosin is an antihypertensive drug that is also used in the treatment of BPH. Blood pressure must be monitored to ensure that the client does not develop hypotensive, syncope, or orthostatic hypotension.

Which is the scientific rationale for administering the 5-alpha-reductase inhibitor dutasteride (AVODART) to a client diagnosed with benign prostatic hypertrophy (BPH)? A. The medication elevates male testosterone levels and decreases impotence B. AVODART causes a rapid reduction in the size of the prostate and relief of symptoms C. The medication decreases the mechanical obstruction of the urethra by the prostate D. AVODART is as fast as surgery in reducing the obstructive symptoms of BPH

C The 5-alpha-reductase inhibitors work by reducing the size of the prostate gland, resulting in a relief of the obstructive symptoms of urgency, frequency, difficulty initiating a urine stream, and nocturia.

A UAP tells the nurse, "I think the client is confused. He keeps telling me he has to void, but that is not possible because he has a catheter in place that is draining well." The nurse should tell the UAP: A. "His catheter is probably plugged. I will irrigate it." B. "That is common problem after prostate surgery. The client only imagines the urge to void." C. "The urge to void is usually created by the large catheter, and he may be having some bladder spasms." D. "I think he may be somewhat confused."

C The indwelling urinary catheter creates the urge to void and can also cause bladder spasms. The nurse should ensure adequate bladder emptying by monitoring urine output and characteristics.

The client who is postoperative TURP asks the nurse, "When will I know if I will be able to have sex after my TURP?" Which response is most appropriate by the nurse? A. "You seen anxious about your surgery." B. "Tell me about your fears of impotency." C. Potency can return in six to eight weeks." D. "Did you ask your doctor about your concern?"

C This is usually the length of time clients need to wait prior to having sexual intercourse; this is the information the client wants to know.

The client diagnosed with BPH and congestive heart failure (CHF) is receiving furosemide (Lasix), a loop diuretic, daily. Which information provided by the unlicensed assistive personnel (UAP) best indicatesto the nurse the medication is effective? A. The UAP recorded the intake as 350 mL and the output of 450 mL B. The UAP stated that the client ambulated to the bathroom without dyspnea C. The UAP emptied a moderate amount of urine from the bedside commode D. The UAP reports that the client lost 1 pound of weigh from the day before

D The most reliable method of determining changed in fluid-volume status is to weigh a client in the same type of clothing at the same time each day. One liter is approximately 0.9 kg, or 2 pounds. This client has lost approximately 500 mL more fluid than was taken in.

The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement first? A. Call the surgeon to inform the HCP of the client's complaint B. Administer the client a narcotic medication for pain C. Explain to the client this sensation happens frequently D. Assess the continuous irrigation catheter for patency

D The nurse should always assess any complaint before dismissing it as a commonly occurring problem.

Which nursing diagnosis is priority for the client who has undergone a TURP? A. Potential for sexual dysfunction B. Potential for an altered body image C. Potential for chronic infection D. Potential for hemorrhage

D This is a potentially life-threatening problem.

The nurse is providing preoperative instructions to a client who is having a transurethral resection of the prostate. The nurse should tell the client: A. "You will have a central venous access inserted just prior to the procedure." B. "Plan on being in the hospital anywhere from 5 to 7 days following the procedure." C. "You will be taught care of the incision and suture line prior to your discharge home" D. "Expect blood in your urine in the first couple of days following the procedure"

D Transurethral resection of the prostate (TURP) is a common surgical procedure used to treat male clients with benign prostate enlargement. The surgery commonly results in blood from the surgery in the urine for the first few days, and the client should not be concerned; the urine will become clear within 2 to 3 days.

The client returned from surgery after having a TURP and has a P 110, R 24, BP 90/40, and cool and clammy skin. Which interventions should the nurse implement? (Select all that apply) A. Assess the urine in the continuous irrigation drainage bag B. Decrease the irrigation fluid in the continuous irrigation catheter C. Lower the head of the bed while raising the foot of the bed D. Contact the surgeon to give an update on the client's condition E. Check the client's postoperative creatinine and BUN

A,C,D -The nurse should assess the drain postoperatively. -The head of the bed should be lowered and the foot should be elevated to shunt blood to the central circulating system. -The surgeon needs to be notified of the change in condition.

In discussing home care with a client after TURP, the nurse should teach the male client that dribbling of urine: A. Can be a chronic problem B. Can persist for several months C. Is an abnormal sign that requires intervention D. Is a sign of healing within the prostate

B Dribbling of urine can occur for several months after TURP. The client should be informed that this is expected and is not an abnormal sign.

The nurse is reviewing the medication history of a client with BPH. Which medication will likely aggravate BPH? A. Metformin B. Buspirone C. Inhaled ipratropium D. Ophthalmic timolol

C Ipratropium is a bronchodilator, and its anticholinergic effects can aggravate urine retention.

The client diagnosed with mild benign prostatic hypertrophy (BPH) is prescribed the 5-alpha-reductase inhibitor finasteride (Proscar) to relieve symptoms of urinary frequency. Which intervention should the clinic nurse implement? A. Tell the client to drink at least 8-10 glasses of water a day B. Schedule an appointment with the HCP for a 1-week follow-up examination C. Have the laboratory draw a prostate-specific antigen level D. Give the client a urinal to measure his daily output of urine

C Proscar decreases serum prostate-specific antigen (PSA) levels. The client should have a PSA level drawn before beginning Proscar and a level drawn after 6 months. If the PSA level does not drop, the client should be assessed for cancer of the prostate.

A client, who had a TURP, has a three-way indwelling urinary catheter with continuous bladder irrigation. In which circumstance should the nurse increase the flow rate of the continuous bladder irrigation? A. When drainage is continuous but slow B. When drainage appears cloudy and dark yellow C. When drainage becomes bright red D. When there is no drainage of urine and irrigating solution

C The decision by the surgeon to insert a catheter after TURP or prostatectomy depends on the amount of bleeding that is expected after the procedure. During continuous bladder irrigation after a TURP or prostatectomy, the rate at which the solution enters the bladder should be increased when the drainage becomes brighter red. The color indicates the presence of blood. Increasing the flow of irrigating solution helps flush the catheter well so that clots do not plug it.

A nurse is caring for a client who has a new diagnosis of BPH. The nurse should anticipate a prescription for which of the following medications? A. Oxybutynin B. Diphenhydramine C. Ipratropium D. Tamsulosin

D Tamsulosin is an alpha-adrenergic receptor antagonist that relaxes the bladder outlet and the prostate gland, which improves urinary flow.

An older adult client is admitted for a TURP to treat BPH. Which item in the client's health history placed him at risk for developing BPH? A. More than one sexual partner B. Sedentary lifestyle C. Age D. Smoking history

C Age is the most common risk factor for BPH. Almost all men will develop BPH if they live long enough.

Which statement indicates discharge teaching has been effective for the client who is postoperative TURP? A. "I will call the surgeon if I experience any difficulty urinating." B. "I will take my Proscar daily, the same as before my surgery." C. "I will continue restricting my oral fluid intake." D. "I will take my pain medication routinely even if I do not hurt."

A This indicates the teaching is effective

A nurse is instructing a client who is scheduled for a transurethral resection of the prostate (TURP) about his postoperative care Which of the following information should the nurse include in the teaching? A. "You may have a continuous sensation of needing to void even though you have a catheter." B. "You will be on bed rest for the first 2 days after the procedure." C. "You will be instructed to limit your fluid intake after the procedure." D. "Your urine should be clear yellow the evening after the surgery."

A To reduce the risk of postoperative bleeding, the client will have a catheter with a large balloon that places pressure on the internal sphincter of the bladder. Pressure on the sphincter causes a continuous sensation of needing to void.

The client asks, "What does an elevated PSA test mean?" On which scientific rationale should the nurse base the response? A. An elevated PSA can result from several different causes B. An elevated PSA can be only from prostate cancer C. An elevated PSA can be diagnostic for testicular cancer D. An elevated PSA is the only test used to diagnose BPH

A An elevated PSA can be from urinary retention, BPH, prostate cancer, or prostate infarct.

The client, admitted to a surgical unit following a TURP, has a CBI running. The nurse assesses the client's urine and find dark red urine containing several small clots. Which intervention should the nurse implement? A. Increase the flow of the bladder irrigation fluid B. Immediately stop the bladder irrigation flow C. Irrigate the urinary catheter manually D. Deflate the balloon on the urinary catheter

A If the urine is dark red, the flow rate of the CBI should be increased. The purpose of the CBI is to remove clots from the bladder and to ensure drainage of urine through the urinary catheter. The flow rate of the CBI fluid should be set so that the outflow remains free from clots and remains light red to pink.

An adult males client has been unable to void for the past 12 hours. The best method for the nurse to use when assessing for bladder distention in a male client is to check for: A. A rounded swelling above the pubis B. Dullness in the lower left quadrant C. Rebound tenderness below the symphysis D. Urine discharge from the urethral meatus

A The best way to assess for a distended bladder in either a male or female client is to check for a rounded swelling about the pubis. This swelling represents the distended bladder rising above the pubis into the abdominal cavity.

A client with mild benign prostatic hyperplasia (BPH) tells the nurse that he prefers to do things "naturally" and doesn't want to take medication for his condition. He asks her if there are some things he can do to help his BPH without drugs. Which lifestyle changes used in the treatment for BPH would the nurse include in the response to the client? (Select all that apply) A. Avoiding drinking fluids within 2 hours of bedtime B. Avoiding alcohol and caffeine C. Reducing stress D. Exercising regularly, including Kegal exercises E. Increasing dietary intake of foods high in potassium

A,B,C,D Lifestyle changes that may help client with mild BPH include avoiding alcohol and caffeine, exercising regularly, including Kegel exercises, avoiding drinking fluids within 2 hours of bedtime, and reducing stress.

A client is admitted to the hospital for elective knee surgery to be performed the following day. The client tells the nurse that he has benign prostatic hyperplasia (BPH). Which assessment findings support the diagnosis of BPH? (Select all that apply) A. Increased time to void B. Fever C. Elevated white blood cell (WBC) count D. Urinary frequency E. Nocturia

A,D,E Clinical manifestations of BPH include weak urinary stream, increased time to void, hesitancy, incomplete bladder emptying, postvoid dribbling, frequency, urgency, incontinence, nocturia, dysuria, and bladder pain.

The client has been prescribed dutasteride (Avodart) for BPH. Which potential adverse effects would the nurse include in the medication teaching for this medication? (Select all that apply) A. Decreased volume of ejaculate B. Renal insufficiency C. Gynecomastia D. Impotence E. Decrease libido

A,D,E Side effects of 5-alpha reductase inhibitors, such as dutasteride (Avodart) and finasteride (Proscar), may include impotence, decreased libido, and decreased volume of ejaculate.

The nurse is caring for a client with a TURP. Which expected outcome indicates the client's condition is improving? A. The client is using the maximum amount allowed by the PCA pump B. The client's bladder spasms are relieved by medication C. The client's scrotum is swollen and tender with movement D. The client has passes a large, hard, brown stool this morning

B Bladder spasms are common, but being relieved with medication indicates the condition is improving.

When providing client teaching about continuous bladder irrigation following prostate surgery, the nurse should tell the client: A. "The catheter is disconnected from the drainage tubing one time per shift to enable manual irrigation on the bladder." B. "The purpose of the irrigation is to keep bladder drainage clear and to prevent the formation of blood clots in the bladder." C. "The fluid drips into the bladder at a slow rate to prevent the effects of overhydration and hyponatremia." D. "The catheter is clamped off approximately 4 hours after returning to the nursing unit."

B Continuous bladder irrigation is performed when urinary surgery results in hematuria. It is accomplished using an indwelling Foley catheter with three lumens. One port is for the balloon, a second port allows irrigant inflow, and a third port enables outflow. The purpose of the irrigation is to achieve and maintain clear outflow and to prevent clot formation within the bladder.

A HCP has prescribed amoxicillin 100 PO two times a day. What should the nurse instruct the client to do? (Select all that apply) A. Drink 300 to 500 mL of fluids daily B. Void frequently, at least every 2 to 3 hours C. Take time to empty the bladder completely D. Take the last dose of the antibiotic for the day at bedtime E. Take the antibiotic with or without food

B,C,D,E Amoxicillin may be given with or without food, but the nurse should instruct the client to obtain an adequate fluid intake to promote urinary output and to flush out bacteria from the urinary tract. The nurse should also encourage the client to void frequently and empty the bladder completely. Taking the antibiotic at bedtime, after emptying the bladder, helps to ensure an adequate concentration of the drug during the overnight period.

A client underwent a TURP 24 hours ago. The nurse providing care for him would be especially vigilant in observing for which complications? (Select all that apply) A. Hypertension B. Hypotension C. Decreased urinary output D. Hemorrhage E. Large blood clots

B,C,D,E During the first 24-48 hours after a TURP, the client should be monitored closely for hemorrhage, the presence of large blood clots, decreased urinary output, increased bladder spasms, decreased hemoglobin and hematocrit, tachycardia, and hypotension.

A nurse in a provider's office is obtaining a history from a client who is undergoing an evaluation for benign prostatic hyperplasis (BPH). The nurse should identify that which of the following findings are indicative of this condition? (Select all that apply) A. Backache B. Frequent urinary tract infections C. Weight loss D. Hematuria E. Urinary incontinence

B,D,E -in the presence of BPH, pressure on urinary structures leads to urinary stasis, which int urn promotes the occurrence of urinary tract infections. -hematuria occurs in the presence of BPH -overflow incontinence occurs in the presence of BPH due to an increased volume of residual urine

The client with known BPH, telephones the clinic nurse with concerns of increased urinary frequency and urgency after having a cold that started a few days ago. Which question should the nurse immediately ask the client? A. "Have you been drinking large amounts of water?" B. "Have you been exercising more than usual?" C. "Have you been taking any over-the-counter cold remedies?" D. "Have you increased the amount of dairy products in your diet?"

C Compounds found in common cough and cold remedies, such as pseudoephedrine and phenylephrine, are alpha-adrenergic agonists that cause smooth muscle contraction. Since the bladder is a smooth muscle, these medications may increase symptoms of urinary urgency and frequency.

The client has BPH. The client is questioning the need for the prescribed tamsulosin. Which explanation by the nurse about tamsulosin is correct? A. Reduces the prostate gland's size to relieve obstructive symptoms B. Decreases the inflammation caused by the prostatic enlargement C. Relaxes the smooth muscle in the prostate to facilitate urine flow D. Decreases urine specific gravity, thus decreasing the risk of UTI

C Tamsulosin (Flomax) is an alpha-adrenergic receptor blocker, which relaxes the smooth muscle in the prostate. This ultimately facilitates urinary flow through the urethra.

A client is to receive belladonna and opium suppositories, as needed, postoperatively after TURP. The nurse should give the client these drugs when he demonstrates signs of: A. A urinary tract infection B. Urine retention C. Frequent urination D. Pain from bladder spasms

D Belladonna and opium suppositories are prescribed and administered to reduce bladder spasms that cause pain after TURP. Bladder spasms frequently accompany urologic procedures. Antispasmodics offer relief by eliminating or reducing spasms. Antimicrobial drugs are used to treat an infection.

A client is scheduled to undergo transurethral resection of the prostate. The procedure is to be done under spinal anesthesia. Postoperatively, the nurse should assess the client for: A. Seizures B. Cardiac arrest C. Renal shutdown D. Respiratory paralysis

D If paralysis of vasomotor nerves in the upper spinal cord occurs when spinal anesthesia is used, the client is likely to develop respiratory paralysis. Artificial ventilation is required until the effects of the anesthesia subside.

The nurse is administering morning medications. Which combination of medications should the nurse question administering? A. Terazosin (Hytrin), an alpha1-adrenergic agonist and captopril (Capoten), an ACE inhibitor B. Finasteride (Proscar), a 5-alpha-reductase inhibitor, and digoxin (Lanoxin), a cardiac glycoside C. Tamsulosin (Flomax), an alpha1-adrenergic agonist, and metformin (Glucophage), a biguanide D. Serenoa repens (saw palmetto), an herbal preparation, and metoprolol (Trprol XL), a beta blocker

A The major adverse effect of Hytrin is hypotension. Most blood pressure-lowering medications can also cause hypotension. The nurse would question administering two medications that can cause the client to become dizzy upon standing, possible resulting in a fall. The medications that shrink the prostate gland were originally developed to treat high blood pressure. This is a safety issue.

The client diagnosed with moderate benign prostatic hypertrophy (BPH) is being treated with the alpha-adrenergic agonist tamsulosin (Flomax). Which intervention should the nurse implement? A. Check the client's blood pressure B. Send a urinalysis to the laboratory C. Determine if the client has nocturia D. Plan a scheduled voiding pattern

A The medications used to treat BPH were originally developed to treat high blood pressure. The client may develop hypotension when taking these medications. This side effect makes them useful for clients who are also hypertensive.

The primary reason for taping an indwelling catheter laterally to the thigh of a male client is to: A. Eliminate pressure at the penoscrotal angle B. Prevent the catheter from kinking in the urethra C. Prevent accidental catheter removal D. Allow the client to turn without kinking the catheter

A The primary reason for taping an indwelling catheter to a male client so that the penis is help in a lateral position is to prevent pressure at the penoscrotal angle.

A client who has just undergone transurethral resection of the prostate (TURP) has developed TURP syndrome, according to the healthcare provider. Which findings during the nursing assessment support this diagnosis? (Select all that apply) A. Decreased hematocrit B. Hypertension C. Confusion D. Hypotension E. Hyponatremia

A,B,C,E TURP syndrome occurs when the client absorbs the irrigation fluids during and after surgery. Clinical manifestations are hyponatremia, decreased hematocrit, hypertension, bradycardia, nausea, and confusion.

The client is one day postoperative TURP. Which task should the nurse delegate to the UAP? A. Increase the irrigation fluid to clear clots from the tubing B. Elevate the scrotum on a towel roll for support C. Change the dressing on the first postoperative day D. Teach the client how to care for the continuous irrigation catheter

B Elevating the scrotum on a towel for support is a task that can be delegated to the UAP.

A nurse is providing discharge instructions to a client who is postoperative following a TURP. Which of the following instructions should the nurse include? (Select all that apply) A. Avoid sexual intercourse for 3 months after the surgery B. If urine appears bloody, stop activity and rest C. Avoid drinking caffeinated beverages D. Take a stool softener once a day E. Treat pain with ibuprofen

B,C,D -excessive activity can cause recurrence of bleeding. The client should rest to promote reclotting at the incisional site -the client should avoid caffeine and other bladder stimulants -the client should take a stool softener to keep the stool soft and thus prevent the complication of bleeding at the time of a bowel movement

Which intervention is priority for a pregnant nurse when administering dutasteride (AVODART) to a client diagnosed with benign prostatic hypertrophy (BPH)? A. Use goggles for personal eye protection B. Protect the nurse's mucosa from contact with liquid C. Ask a male nurse to administer the medication D. Wear gloves while administering the medication

D Dutasteride is considered a category X medication and will cause harm to a developing fetus. The medication can be absorbed through the skin. The nurse should wear gloves when administering the medication. Men should not donate blood for at least 6 months after discontinuing the medication to avoid administration of the medication to a pregnant client through the transfusion.

When emptying the client's bladder during a urinary catheterization, the nurse should allow the urine to drain from the bladder slowly to prevent: A. Renal failure B. Abdominal cramping C. Possible shock D. Atrophy of bladder musculature

C Rapid emptying of an overdistended bladder may cause hypotension and shock due to the sudden change of pressure within the abdominal viscera. The nurse should empty the bladder slowly.

The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one day postoperative TURP. Which intervention should the nurse implement? A. Remove the indwelling catheter B. Titrate the NS irrigation to run faster C. Administer protamine sulfate IVP D. Administer vitamin K slowly

B Increasing the irrigation fluid will flush out the clots and blood.

The nurse should specifically assess a client with prostatic hypertrophy for: A. Voiding at less frequent intervals B. Difficulty starting the flow of urine C. Painful urination D. Increased force of the urine stream

B Signs and symptoms of prostatic hypertrophy include difficulty starting the flow of urine, urinary frequency and hesitancy, decreased force of the urine stream, interruptions in the urine stream when voiding, and nocturia.