A client, who has undergone a transurethral resection of the bladder tumor (TURBT), complains of bladder spasms and has continuous bladder irrigation running. Which nursing action is most appropriate for this problem?

Instruct the client to "bear down" to relieve the spasms

Warm the irrigation solution to body temperature

Administer the prescribed prn belladonna and opium suppository

Administer the prescribed prn meperidine 75 mg IV

Answer and Explanation

The Correct Answer is C

A.   This is not an appropriate action as it can increase pressure on the bladder and worsen the spasms.
B.   While warming the irrigation solution can help to prevent discomfort, it is not the most effective way to address the bladder spasms.
C.   Belladonna and opium suppositories are commonly used to relieve bladder spasms. They work by relaxing the muscles in the bladder and reducing pain. In a client who has undergone TURBT and is experiencing continuous bladder irrigation, these suppositories can be an effective way to manage discomfort.
D.   Meperidine is a narcotic pain reliever that can be used to manage pain after surgery. However, it is not specifically indicated for bladder spasms and may not be the most appropriate medication in this case.

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Correct Answer is D

Explanation

A. While pain can occur post-operatively and may be a sign of complications, it is not a direct indicator of bleeding. Pain can result from normal healing, surgical trauma, or other complications, but by itself, it does not specifically point to bleeding at the surgical site.
B. An increased blood pressure might not necessarily indicate bleeding. In some cases, blood pressure may increase due to pain, anxiety, or other factors. However, a significant drop in blood pressure would be more indicative of bleeding, especially in conjunction with other symptoms.
C. A decreased white blood cell count (leukopenia) is not typically associated with bleeding at the surgical site. In fact, following surgery, one might expect the white blood cell count to be normal or slightly elevated due to the body’s response to surgery.
D. This finding is indicative of bleeding at the surgical site. Blood on the pillow would suggest that there is active bleeding that has escaped from the surgical site, which is a significant concern that requires immediate assessment and intervention.

A. The patient should be placed in isolation to prevent radiation exposure to others. B. The patient should avoid consuming any food or fluids for 24 hours prior to the treatment. C. The patient should avoid all physical activity for 72 hours after the treatment. D. The patient should discontinue all other medications for a week before the treatment.

Correct Answer is A

Explanation

A. This is a valid consideration. Patients receiving radioactive iodine may emit radiation, so placing them in a private room can help minimize exposure to family members and staff. Isolation may be more strictly enforced based on the dose administered and hospital protocols.
B. This is generally not required for radioactive iodine treatment. Patients are often advised to have a low-iodine diet in the weeks leading up to treatment, but complete fasting for 24 hours prior is not standard practice. Clear instructions from the healthcare provider should be followed regarding diet.
C. This is typically not a requirement. While some patients may be advised to avoid strenuous activities immediately after treatment, there is no strict guideline stating that all physical activity must be avoided for 72 hours. Patients are usually encouraged to follow normal activities while being mindful of minimizing close contact with others.
D. This statement is generally incorrect. While certain medications may need to be adjusted or stopped before radioactive iodine treatment (for instance, thyroid medications), it’s not a blanket recommendation to stop all medications for a week. Patients should consult with their healthcare provider for personalized advice regarding their specific medications.

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A client, who has undergone a transurethral resection of the bladder tumor (TURBT), complains of bladder spasms and has continuous bladder irrigation running. Which nursing action is most appropriate for this problem?

Nursing Test Bank

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Explanation

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Explanation

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