A nurse is caring for a client who is 2 hours postoperative following a transurethral resection of the prostate (TURP) gland. Which of the following assessments should the nurse view as an indication of a postoperative complication?

Choice A reason:Scheduling the procedure five days before the expected menses would place it in the late proliferative phase, which risks missing ongoing menstrual bleeding and could coincide with implantation if the client ovulated early. Best practice is to perform the test after menstruation ends but before ovulation—usually within 12 days of the first day of the last period—to ensure the client is not pregnant.

Choice B reason:
Diarrhea is not a common side effect of HSG. The procedure involves the insertion of a dye into the uterine cavity to visualize the fallopian tubes and uterus via X-ray. While some discomfort, cramping, or spotting may occur, diarrhea is not typically expected.

Choice C reason:
There is no requirement for a client to be on a liquid diet following an HSG procedure. The client can usually resume normal activities and diet immediately after the procedure unless otherwise instructed by their healthcare provider.

Choice D reason:
Referred shoulder pain can occur when contrast fluid spills through a patent tube into the peritoneal cavity, irritating the diaphragm’s undersurface and eliciting pain perceived at the shoulder via the phrenic nerve. Clients should be advised this is normal, short-lived, and relieved by positioning or mild analgesics.

Choice A reason:
Reducing the dosage of methotrexate during pregnancy is not a safe option because methotrexate is contraindicated during pregnancy due to its potential to cause birth defects and other adverse pregnancy outcomes.

Choice B reason:
While dietary modifications may be necessary during pregnancy, this is not specifically related to the use of methotrexate. The primary concern with methotrexate and pregnancy is the risk it poses to the developing fetus, not dietary interactions.

Choice C reason:
Breastfeeding while taking methotrexate is not recommended. Methotrexate can be excreted in breast milk and may harm a nursing infant.

Choice D reason:
Methotrexate should indeed be discontinued at least 3 months prior to a planned pregnancy. This is to ensure that the drug is completely cleared from the body, as it can cause serious birth defects and other pregnancy-related complications.