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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While it's important to monitor the surgical dressing, changing it too frequently can increase the risk of infection and disrupt healing. Instead, nurses typically assess the dressing regularly and only change it if it's overly saturated or if ordered by a physician. It’s essential to follow specific protocols regarding dressing changes.
B. A While breast prostheses can be an important part of post-mastectomy care for some clients, it is usually recommended that clients wait until they have fully healed and received counseling regarding their options. Immediate encouragement may be premature, as physical and emotional adjustments take time after surgery.
C. This is an appropriate intervention. After axillary lymph node dissection, there is a risk of lymphedema in the affected arm. Placing a limb alert bracelet serves as a reminder to healthcare providers to avoid taking blood pressure or performing venipunctures on the affected arm, thus helping prevent complications.
D. While PCA can be an effective method for managing postoperative pain, the timing and dosage should be based on the specific prescription and the client's individual needs. It’s crucial to educate the client about the PCA device and its use, but the specific interval may vary based on the medication's parameters and the patient's condition.
Correct Answer is A
Explanation
A. Ascites is a condition where excess fluid accumulates in the abdominal cavity. It is a common finding in advanced-stage ovarian cancer as the cancer can spread to the abdominal organs and lymph nodes, leading to fluid buildup.
B. Chest pressure is not a typical symptom of advanced-stage ovarian cancer. It might be associated with other conditions, such as heart disease or lung problems.
C. Painful urination is not a common symptom of advanced-stage ovarian cancer. It might be associated with other conditions, such as urinary tract infections or bladder problems.
D. Excessive flatus is not a typical symptom of advanced-stage ovarian cancer. It might be associated with other gastrointestinal conditions.
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