Urinary Disorders Q 143 - Gyan Darpan : Learning Portal
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Monday, 4 April 2022

Urinary Disorders Q 143

A priority nursing diagnosis for the client who is being discharged home 3 days after a TURP would be:
    A. Deficient fluid volume
    B. Imbalanced Nutrition: Less than Body Requirements
    C. Impaired Tissue Integrity
    D. Ineffective Airway Clearance

Correct Answer: A. Deficient fluid volume

Deficient Fluid Volume is a priority diagnosis because the client needs to drink a large amount of fluid to keep the urine clear. The urine should be almost without color. About two (2) weeks after a TURP, when desiccated tissue is sloughed out, a secondary hemorrhage could occur. The client should be instructed to call the surgeon or go to the ED if at any time the urine turns bright red.

Option B: The client is not specifically at risk for nutritional problems after a TURP. Encourage fluid intake to 3000 mL as tolerated. Limit fluids in the evening, once the catheter is removed. Maintains adequate hydration and renal perfusion for urinary flow. Reducing fluid intake at the right schedule decreases the need to void and interrupt sleep during the night.
Option C: The client is not specifically at risk for impaired tissue integrity because there is no external incision. Maintain a sterile catheter system. Provide regular catheter and meatal care with soap and water. Apply antibiotic ointment around the catheter site. Measures to prevent the introduction of bacteria that may cause infection or sepsis.
Option D: The client is not specifically at risk for airway problems because the procedure is done after spinal anesthesia. Monitor vital signs, noting low-grade fever, chills, rapid pulse and respiration, restlessness, irritability, disorientation. Patient who has had a cystoscopy and/or TURP is at increased risk for surgical or septic shock related to manipulation and instrumentation.

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