BPH, TURP/CBI, HPV, HSV

A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take? 1- Discontinue the irrigations. 2- Increase the rate of the IV fluids. 3- Administer a unit of packed red blood cells. 4- Prepare the patient for an ECG.

1

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include: 1- continuous inflow and outflow of irrigation solution. 2- intermittent inflow and continuous outflow of irrigation solution. 3- continuous inflow and intermittent outflow of irrigation solution. 4- intermittent flow of irrigation solution and prevention of hemorrhage.

1

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 (1) day postoperative TURP. Which intervention should the nurse implement? 1. Remove the indwelling catheter. 2. Titrate the NS irrigation to run faster. 3. Administer protamine sulfate IVP. 4. Administer vitamin K slowly.

2

Which treatment regimen is preferred in patients with severe genital herpes simplex virus (HSV) infection?

Acyclovir intravenous (IV) administration with hospitalization

A nurse is caring for a client who has continuous bladder irrigation following a transurethral resection of the prostate (TURP). Which of the following findings should the nurse report to the provider? A. Output equal to the instilled irrigant B. Client report of bladder spasms C. Viscous urinary output with clots D. Client report of a strong urge to urinate

C.vicious urinary output with clots ; nurse should report bright red with clots or urine bc its an indication of arterial bleeding. BLADDER SPASM, STRONG URGE TO URINATE are an expected manifestation

The client with benign prostatic hyperplasia (BPH) is considering use of medication in the management of symptoms. Which of the following drugs reduces the size of the prostate without lowering circulating levels of testosterone?

Finasteride (Proscar)

A patient is infected with the herpes virus exhibiting lesions on the genital area. What instructions should the nurse give to this patient? Select all that apply. Maintain good hygiene. Keep the lesions clean and dry. Take frequent sitz baths. Burst the vesicles to drain the fluid. Use hot fomentation on the vesicles. Wear loose-fitting cotton undergarments.

Maintain good hygiene. Keep the lesions clean and dry. Take frequent sitz baths. Wear loose-fitting cotton undergarments.

A patient is recovering in the PACU following a transurethral resection of the prostate (TURP). The patient is receiving continuous bladder irrigation (CBI), and the nurse has observed several clots in the collection bag and tubing. In the last few minutes, output has ceased despite the continued infusion of normal saline through the patient's triple-lumen urinary catheter. How should the nurse respond to this assessment finding?

Manually irrigate the patient's catheter with normal saline.

Which statement about genital herpes (GH) is correct?

The infection is transmittable even without presenting symptoms.

The physician recommends that parents have their daughter vaccinated with HPV vaccine. What is this vaccine for? a) Help prevent breast cancer b) Help prevent leukemia c) Help prevent lung cancer d) Help prevent cervical cancer

d) Help prevent cervical cancer

A female patient has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this patient? A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually. B. The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex. C. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. D. The poten

a

Which of the following sexually transmitted infections (STIs) could be transmitted perinatally? A Herpes simplex B Gonorrhea C Trichomoniasis D Chlamydia

a

A public health nurse is participating in a campaign aimed at preventing cervical cancer. What strategies should the nurse include is this campaign? Select all that apply. A) Promotion of HPV immunization B) Encouraging young women to delay first intercourse C) Smoking cessation D) Vitamin D and calcium supplementation E) Using safer sex practices

abce

A 20 year old female comes to the clinic and tells the nurse she thinks she has herpes and she would like a cure. Which is the nurse's best response: A) Assume the woman is promiscuous and lecture her on the benefits of abstinence. B) Inform the woman there is no cure for Herpes, but antiviral medications are available to lesson the severity of symptoms and the number of outbreaks. C) After examining the woman, tell her it's better to assume it's just a heat rash since there isn't a cure anyway.

b

A patient has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the patient? a) The virus causes "cold sores" of the lips. b) Treatment is focused on relieving symptoms. c) The virus may be cured with antibiotics. d) The virus when active may not be contracted during intercourse.

b

The school health nurse is conducting a teaching session for parents to provide information about the (HPV) vaccination. What prevention information should the nurse include in the session? A. The HPV vacc prevents the future need for cervical cancer screening in women. B. The vacc is available only to girls but, in the long term, protects both genders from sexually transmitted infections. C. The effect of the vacc is optimized if it is administered before the child becomes sexually active. D.

c

Which characteristics describe transurethral resection of the prostate (TURP)? (Select all that apply) a. Best used for a very large prostate gland b. Inappropriate for men with rectal problems c. Involves an external incision prostatectomy d. Uses transurethral incision into the prostate e. Most common surgical procedure to treat BPH f. Resectoscopic excision and cauterization of prostate tissue

e. Most common surgical procedure to treat BPH f. Resectoscopic excision and cauterization of prostate tissue

When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint? 1- Dark brown urine 2- Increased effort to void 3- Narrowing of urinary stream 4- Nocturia

2

A client with benign prostatic hyperplasia undergoes a transurethral resection of the prostate. Postoperatively the client is receiving continuous bladder irrigations. The nurse assesses the client for manifestations of transurethral resection syndrome. Which assessment data would indicate the onset of this syndrome? 1. Tachycardia and diarrhea 2. Bradycardia and confusion 3. Increased urinary output and anemia 4. Decreased urinary output and bladder spasms

2. Bradycardia and confusion

Which intervention is priority for a pregnant nurse when administering dutasteride to a client diagnosed with BPH? 1. Use goggles for personal eye protection. 2. Protect the nurse's mucosa from contact with liquid. 3. Ask a male nurse to administer the medication. 4. Wear gloves while administering the medication

4

The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia? 1. Nocturia 2. Scrotal edema 3. Occasional constipation 4. Decreased force in the stream of urine

4. Decreased force in the stream of urine (Decreased force in the stream of urine is an early symptom of BPH. The stream later becomes weak and dribbling. The pt then may develop hematuria, frequency, urgency, urge incontinence, and nocturia.) NCLEX

A nurse is instructing a client who is scheduled for (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. "You may have a continuous sensation of needing to void even though you have a catheter.

A nurse is reinforcing teaching with a client who is preoperative prior to a transurethral resection of the prostate (TURP). Which of the following statements indicates an understanding of the information. a. I will expect my urine to be cloudy after having this procedure b. I will feel the urge to urinate following this procedure. c. I will not need to have a urinary catheter following this procedure. d. At least I won't have leakage of urine after having this procedure.

B. I will feel the urge to urinate following this procedure.

. After having transurethral resection of the prostate (TURP), a client returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client's catheter is occluded? a. The normal saline irrigant is infusing at a rate of 50 drops/minute. b. The client reports bladder spasms and the urge to void. c. The urine in the drainage bag appears red to pink. d. About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage

b. The client reports bladder spasms and the urge to void. Rationale: Reports of bladder spasms and the urge to void suggest that a blood clot may be occluding the catheter. After TURP, urine normally appears red to pink, and normal saline irrigant usually is infused at a rate of 40 to 60 drops/minute or according to facility protocol. The amount of returned fluid (1,200 ml) should correspond to the amount of instilled fluid, plus the client's urine output (1,000 ml + 200 ml), which reflects catheter patency.

A nurse is providing discharge instructions to a client who is postoperative from 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 (Motrin).

B. If urine appears bloody, stop activity and rest. C. Avoid drinking caffeinated beverages. D. Take a stool softener once a day. (avoid intercourse 2-6 weeks after surgery, NSAIDs can cause bleeding)

A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following? A) Babies delivered vaginally may become infected with the virus. B) Recommended treatment is excision of the herpes lesions. C) Pain generally does not occur with a herpes outbreak during pregnancy. D) Pregnancy may exacerbate the mothers symptoms, but poses no risk to the infant.

a

The nurse is providing care to a client who has had a transurethral resection of the prostate. The client has a three-way catheter drainage system in place for continuous bladder irrigation. The nurse anticipates that the catheter may be removed when the urine appears as which of the following? a. Light pink with few red streaks b. Reddish-pink with numerous clots c. Dark amber with copious mucous d. Light yellow and clear

d. Light yellow and clear Rationale: Typically a three-way catheter drainage system is removed when the urine appears clear and amber (light yellow). Reddish-pink urine with clots usually occurs in the immediate postoperative period. Eventually the urine becomes light pink within 24 hours after surgery. Dark amber urine suggests concentrated urine commonly associated with dehydration.

A nurse is assessing a client who is 4 hr postoperative following a transurethral resection of the prostate and has an indwelling urinary catheter in place. Which of the following findings should the nurse expect? A. Blood-tinged urine in the drainage bag B. Catheter tubing coiled at the client's side C. Client report of severe bladder spams D. Urinary output of 20 mL/hr

A. Blood-tinged urine in the drainage bag

The nurse provides discharge teaching to a patient following a TURP and determines that the patient understands the instructions when he makes which statement? a. "I should use daily enemas to avoid straining until healing is complete." b. "I should avoid heavy lifting, climbing, and driving until my follow-up visit." c. "At least I don't have to worry about developing cancer of the prostate now." d. "Every day I should drink 10 to 12 glasses of liquids such as coffee, tea, or soft drinks."

b. "I should avoid heavy lifting, climbing, and driving until my follow-up visit."

In which group is it most important for the client to understand the importance of an annual Papanicolaou test? A. Clients with a history of recurrent candidiasis B. Clients with a long history of hormonal contraceptive use C. Clients with a pregnancy before age 20 D. Clients infected with the human papillomavirus (HPV)

d

A client is scheduled for a transurethral resection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met? a. "I'll have to stay in the hospital for about 3 to 4 days after the surgery." b. "I'll have a small incision on my lower abdomen after the procedure." c. "The surgeon is going to remove the entire prostate gland." d. "The surgeon is going to insert a scope through my ur

d. "The surgeon is going to insert a scope through my urethra to remove a portion of the gland." Rationale: TURP involves the surgical removal of the inner portion of the gland through an endoscope inserted through the urethra. There is no external skin incision. Typically, the procedure is performed in an outpatient setting but may require an overnight hospital stay.

A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take? a. Increase the rate of the IV fluids. b. Prepare the patient for an ECG. c. Administer a unit of packed red blood cells. d. Discontinue the irrigations.

d. Discontinue the irrigations. Rationale: Transurethral resection syndrome is a rare but potentially serious complication of TURP. Symptoms include lethargy, hypotension, and muscle spasms. The first action the nurse should take is to discontinue irrigation. The other interventions listed are not appropriate.

A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged IV pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow? a. Attaching the infusion set to an infusion pump b. Counter-balancing the I.V. pole c. Collecting a urine specimen before beginning irrigation d. Evaluating

d. Evaluating patency of the drainage lumen Rationale: The nurse should evaluate patency of the drainage tubing before leaving the client's room. If the lumen is obstructed, the solution infuses into the bladder but isn't eliminated through the drainage tubing, a situation that may cause client injury. Balancing the pole is important; however, the nurse would have had to address this issue immediately after hanging the 2 L bag. Using an I.V. pump isn't necessary for continuous bladder irrigation. Unless specifically ordered, obtaining a urine specimen before beginning continuous bladder irrigation isn't necessary.