TURP transurethral resection of the prostate
An older man is returned to his hospital room three hours after a transurethral resection of the prostate (TURP). The patient has a continuous bladder irrigation (CBI). Which of the following observations, if made by the nurse, requires an intervention? 1. The patient is in bed with his legs drawn up to his abdomen. 2. There is 500 cc fluid in the urinary drainage bag. 3. There is 350 cc of reddish urine in the drainage bag. 4. The head of the patient's bed is elevated 45 degrees
Strategy: "Requires an intervention" indicates a potential complication. 1) CORRECT— indicates pain; also, catheter is taped to thigh, and leg should be kept straight to maintain traction on the catheter 2) expected due to the CBI; assess for shock and hemorrhage; check dressing and drainage; urine may be bright red for 12 h; monitor vital signs 3) expected drainage soon after surgery; CBI contains isotonic fluid used to keep the catheter patent 4) no restriction on positioning as long as leg that has catheter taped to it is straight
After the urinary catheter is removed in the TURP client, what are 3 priority nursing actions?
Continued strict I&O. Continued observations for hematuria. Inform client brning and frequency may last for a week.
A client who returns to the surgical floor after undergoing transurethral resection of the prostate complains of pain. Which action should the nurse take first?
Check the client's medical record for postoperative orders.
Following discharge teaching for a patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), the nurse determines that additional instruction is needed when the patient says, _______________
"I should call the doctor if I have any incontinence at home."
Following transurethral resection of the prostate gland (TURP), hematuria should subside by what postoperative day?
4th day
The nurse is completing an intake and output record for a client who is receiving continuous bladder irrigation after transurethral resection of the prostate. How many milliliters of urine should the nurse record as output for her shift if the client received 1,800 ml of normal saline irrigating solution and the output in the urine drainage bag is 2,400 ml?
600
When teaching a patient who is scheduled for a transurethral resection of the prostate (TURP) about continuous bladder irrigation, which information will the nurse include?
Bladder irrigation prevents obstruction of the catheter after surgery.
The nurse hangs a new 3000 mL bag of irrigating fluid for a postoperative client who has had a transurethral resection of the prostate and sets the irrigation rate based on:
Color of the client's urine.
Romeo Diaz, age 78, is admitted to the hospital with the diagnosis of benign prostatic hyperplasia (BPH). He is scheduled for a transurethral resection of the prostate (TURP). It would be inappropriate to include which of the following points in the preoperative teaching? A. TURP is the most common operation for BPH. B. xplain the purpose and function of a two-way irrigation system. C. Expect bloody urine, which will clear as healing takes place. D. He will be pain free.
D Surgical interventions involve an experience of pain for the client which can come in varying degrees. Telling the pain that he will be pain free is giving him false reassurance.
After a transurethral resection of the prostate (TURP), a patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes a decrease in urine output and clots in the urine. Which action should the nurse take first?
Manually instill and then withdraw 50 mL of saline into the catheter.
The nurse is caring for a man who has returned to the unit from the recovery room following a transurethral resection of the prostate (TURP). His urinary drainage bag is filled with dark red fluid with obvious clots. He is having painful bladder spasms. What would the nurse do first?
Report the assessments to his urologist.
A client with benign prostatic hyperplasia (BPH) doesn't respond to medical treatment and is admitted to the facility for surgical intervention. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for treatment of BPH?
Transurethral resection of the prostate (TURP)
The client underwent a transurethral resection of the prostate gland 24 hours ago and has a continuous bladder irrigation. Which of the following nursing interventions is appropriate?
Use aseptic technique when irrigating the catheter.
A 3-way indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to inflating the balloon, the functions of the three lumens include:
continuous inflow and outflow of irrigation solution.
A patient who has been recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because he is afraid it might affect his ability to have intercourse. Which action should the nurse take?
Teach that ED is not a common complication following a TURP.
A 55-year old client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, nurse Gail asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal? a. Transurethral resection of the prostate (TURP) b. Suprapubic prostatectomy c. Retropubic prostatectomy d. Transurethral laser incision of the prostate
Answer A. TURP is the most widely used procedure for prostate gland removal. Because it requires no incision, TURP is especially suitable for men with relatively minor prostatic enlargements and for those who are poor surgical risks. Suprapubic prostatectomy, retropubic prostatectomy, and transurethral laser incision of the prostate are less common procedures; they all require an incision.
After having transurethral resection of the prostate (TURP), a Mr. Locke 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 urine in the drainage bag appears red to pink. b. The client reports bladder spasms and the urge to void. c. The normal saline irrigant is infusing at a rate of 50 drops/minute. d. About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned.
Answer B. 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.
After undergoing transurethral resection of the prostate to treat benign prostatic hyperplasia, a male client returns to the room with continuous bladder irrigation. On the first day after surgery, the client reports bladder pain. What should nurse Andrew do first? a. Increase the I.V. flow rate. b. Notify the physician immediately. c. Assess the irrigation catheter for patency and drainage. d. Administer meperidine (Demerol), 50 mg I.M., as prescribed.
Answer C. Although postoperative pain is expected, the nurse should make sure that other factors, such as an obstructed irrigation catheter, aren't the cause of the pain. After assessing catheter patency, the nurse should administer an analgesic, such as meperidine, as prescribed. Increasing the I.V. flow rate may worsen the pain. Notifying the physician isn't necessary unless the pain is severe or unrelieved by the prescribed medication.
The client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Nurse Yoly is aware that the following nursing interventions is appropriate? a. Tell the client to try to urinate around the catheter to remove blood clots. b. Restrict fluids to prevent the client's bladder from becoming distended. c. Prepare to remove the catheter. d. Use aseptic technique when irrigating the catheter.
Answer D. If the catheter is blocked by blood clots, it may be irrigated according to physician's orders or facility protocol. The nurse should use sterile technique to reduce the risk of infection. Urinating around the catheter can cause painful bladder spasms. Encourage the client to drink fluids to dilute the urine and maintain urine output. The catheter remains in place for 2 to 4 days after surgery and is only removed with a physician's order.
After having a 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?
The client reports bladder spasms and the urge to void.
