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:

Asking questions about the information on her postoperative care pamphlet is a positive behavior indicating that the client is proactive in understanding her care and recovery process. It shows engagement and a desire to comply with medical advice, which is beneficial for recovery.

Choice B reason:

Refusing to look at the dressing or surgical incision may indicate psychological distress and difficulty in accepting the physical changes following a mastectomy. This behavior can be a sign of avoidance and a potential struggle with body image and the emotional impact of breast loss. It's important for healthcare providers to recognize this as a call for psychological support and possible referral to counseling services.

Choice C reason:

Performing arm exercises once or twice a day is typically recommended as part of the postoperative care after a mastectomy to prevent stiffness and improve mobility. This behavior suggests that the client is following postoperative instructions and actively participating in her recovery.

Choice A reason:

While explaining discharge instructions is an important part of patient education and ensuring safety after leaving the hospital, it is not the immediate priority. The nurse must first address any potential medical issues that could compromise the patient's health, such as circulation and nerve function in the affected limb.

Choice B reason:

Applying an ice pack to the casted leg can help reduce swelling and provide comfort to the client. This is often recommended for the first 24 to 72 hours after the cast is applied, especially if the cast is on a leg. However, this is secondary to assessing the neurovascular status of the limb.

Choice C reason:

Performing a neurovascular assessment is the priority action for the nurse. This assessment includes checking for sensation, warmth, capillary refill, pulses, and movement. It is crucial to identify any signs of compromised blood flow or nerve injury early to prevent further complications.

Choice D reason:

Providing reassurance to the client and parents is important for emotional support and can help alleviate anxiety. However, the nurse's immediate priority is to ensure the physical well-being of the client, which includes performing a neurovascular assessment to detect any urgent issues.