A nurse is assessing a client who is 2 days postoperative following a transurethral resection of the prostate and has an indwelling urinary catheter in place. Which of the following findings should the nurse expect?

Small clots with tissue in the urine

Dark red urine

Urinary output 25 mL/hr

Pain of 8 on a scale of 0 to 10

Answer and Explanation

The Correct Answer is A

A. Small clots with tissue in the urine. It is expected for a client 2 days post-TURP to have small clots and tissue debris in the urine as part of the healing process. Continuous bladder irrigation (CBI) often helps clear these.

B. Dark red urine. Bright red or dark red urine can indicate active bleeding, which is not expected 2 days post-op and requires immediate intervention.

C. Urinary output 25 mL/hr. This is too low (normal output should be at least 30 mL/hr) and could indicate catheter blockage, dehydration, or renal impairment, which is not expected.

D. Pain of 8 on a scale of 0 to 10. Mild discomfort is expected, but severe pain (8/10) is abnormal and could indicate bladder spasms, catheter blockage, or another complication requiring intervention.

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Correct Answer is C

Explanation

A. Bradycardia is not expected with dehydration. Instead, tachycardia occurs as a compensatory response to low blood volume.
B. Edema is not a symptom of dehydration. Instead, dehydration leads to decreased tissue perfusion and dry mucous membranes.
C. Hypotension occurs due to decreased blood volume from fluid loss, leading to low blood pressure and potential dizziness or weakness.
D. Crackles are not expected in dehydration. Instead, lung sounds are typically clear unless another condition is present.

A. Constipation B. Visual disturbances C. Dry mouth D. Irregular pulse

Correct Answer is D

Explanation

A. Constipation is a common side effect of risperidone due to its anticholinergic effects. However, it is not the priority because it is not immediately life-threatening.
B. Visual disturbances can occur with risperidone, but they are not as urgent as cardiovascular abnormalities.
C. Dry mouth is another anticholinergic side effect, but it is not a priority concern compared to an irregular pulse.
D. Irregular pulse is the priority finding because risperidone can prolong the QT interval, increasing the risk of serious cardiac arrhythmias, including torsades de pointes, which can be life-threatening. Therefore, this finding should be reported to the provider immediately.

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A nurse is assessing a client who is 2 days postoperative following a transurethral resection of the prostate and has an indwelling urinary catheter in place. Which of the following findings should the nurse expect?

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