A nurse is caring for a client who is 5 hours postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?

Choice A Reason:
The instruction to urinate a small amount into the toilet before collecting the sample is correct because it helps clear the urethra of organisms that could contaminate the specimen. This initial void helps to flush out bacteria that are present at the opening of the urethra.

Choice B Reason:
This choice is incorrect because urine samples should be kept at body temperature and sent to the lab as soon as possible. Cooling the urine can lead to precipitation of solutes and may affect the results of certain tests.

Choice C Reason:
This statement is incorrect. The proper technique for cleansing prior to urine collection is to wipe from front to back, not back to front. Wiping from back to front can contaminate the urine with bacteria from the anal area.

Choice D Reason:
It is advisable not to collect a urine sample during menstruation unless absolutely necessary because menstrual blood can contaminate the urine specimen, leading to inaccurate test results.

Choice A reason:
Increased hematocrit levels are not typically associated with fluid overload. In fact, hematocrit may decrease in fluid overload due to hemodilution, where the volume of plasma increases, diluting the concentration of red blood cells.

Choice B reason:
An increased respiratory rate can be a sign of fluid overload. As fluid accumulates in the body, it can lead to pulmonary edema, which is the buildup of fluid in the lung's air sacs. This can impair gas exchange and lead to increased respiratory rate as the body attempts to compensate for reduced oxygenation.

Choice C reason:
Increased blood pressure is a common finding in fluid overload. As the volume of fluid in the bloodstream increases, it can lead to higher blood pressure due to the extra fluid that the heart must pump and the increased resistance in the blood vessels.

Choice D reason:
Increased temperature is not a direct finding associated with fluid overload. While fever may indicate an infection or other conditions, it is not specifically related to the volume of fluid in the body.

Choice E reason:
An increased heart rate may occur in fluid overload as the heart works harder to pump the excess volume of blood through the body. This compensatory mechanism aims to maintain adequate circulation and blood pressure despite the increased fluid volume.