A nurse in a community clinic is caring for a client who requests assistance with smoking cessation. The nurse should expect a prescription for which of the following medications?

Rationale:

A. First-degree atrioventricular block: A first-degree AV block is characterized by a prolonged but consistent P-R interval greater than 0.20 seconds. A P-R interval of 0.35 seconds with no dropped beats is a classic sign of this dysrhythmia.

B. Atrial fibrillation: Atrial fibrillation presents with an irregularly irregular rhythm and absent distinct P waves. The presence of a consistent P-R interval rules out atrial fibrillation.

C. Premature atrial complexes: PACs are identified by early P waves that may look different from sinus P waves, often followed by a normal QRS complex. They do not cause consistently prolonged P-R intervals.

D. Complete heart block: Complete (third-degree) heart block involves no association between P waves and QRS complexes. The atria and ventricles beat independently, which contradicts the presence of a consistent P-R interval.

Rationale:

A. Perform the Credé’s maneuver: This manual technique is used to assist bladder emptying in clients with urinary retention due to neurogenic bladder. It is not appropriate or necessary when continuous bladder irrigation is in place and the catheter is draining.

B. Maintain the irrigation solution rate: Pink-tinged urine is expected during the early postoperative period following TURP, indicating mild bleeding. There is no need to adjust the irrigation rate unless there are signs of obstruction or bright red bleeding with clots.

C. Replace the indwelling urinary catheter: Catheter replacement is only necessary if there is a blockage or malfunction. In this case, the system appears to be functioning correctly, and there’s no indication of obstruction.

D. Warm the irrigation solution: Warming the irrigation fluid is not required and does not affect hematuria. The solution should be at room temperature unless otherwise prescribed. Hematuria at this stage is managed by monitoring, not fluid temperature changes.