A nurse is collecting data from a client who has been taking medroxyprogesterone for 6 months. Which of the following statements by the client should the nurse identify as the priority to report?

A) Occasional small clots in the urine:
Occasional small clots can be expected after a transurethral resection of the prostate (TURP) due to the surgical trauma to the prostate and surrounding tissues. However, any change in the nature or frequency of clots, or if they become larger, should be reported, but small clots are not immediately concerning in the early postoperative period.

B) Urine output of 300 mL over 8 hr:
This urine output is within a reasonable range. While urine output may be initially monitored closely after TURP, a volume of 300 mL over 8 hours does not constitute a concerning finding. It may be less than expected, but it is not an emergency. The nurse should continue to monitor urine output, but this is not immediately concerning unless the client has a significantly reduced or absent output.

C) Dark red urine:
Dark red urine is a concerning finding as it may indicate excessive bleeding or hemorrhage, especially within the first 24 hours after TURP. While some initial hematuria (blood in the urine) is common, the urine should not remain dark red or worsen. This could indicate active bleeding or a clot obstructing the urinary flow, which requires immediate intervention and reporting to the healthcare provider to prevent complications.

D) Frequent urge to urinate:
A frequent urge to urinate is not an unusual finding following TURP, as the bladder may be irritated due to the catheter or residual inflammation from the surgery. While it is a discomforting symptom, it is typically not an immediate concern and often resolves as the healing process progresses. However, persistent or painful urination may require further evaluation.

A) Mix the 2 medications together prior to administration: It is not recommended to mix medications together before administering them through an NG tube unless specifically instructed by a healthcare provider or the pharmacy. Some medications can interact or precipitate when combined, which could reduce their effectiveness or cause harmful reactions. Therefore, it is safer to administer each medication separately, followed by a flush.

B) Add the medications to a small amount of the formula: Medications should not be mixed with enteral feeding formula, as it can affect the absorption of the medication and alter its effectiveness. Additionally, the medications could interact with components of the formula, leading to complications or reduced efficacy.

C) Flush the tube with at least 30 mL of sterile water prior to administering the medications: This is the correct action. Flushing the NG tube with 30 mL of sterile water before administering medications helps ensure the tube is clear and patent, preventing clogging. It also prepares the tube to receive the medications, ensuring proper delivery into the gastrointestinal tract.

D) Connect the NG tube to suction 10 minutes after administration of the medications: Connecting the NG tube to suction immediately after medication administration could remove the medications before they are absorbed. It is important to wait at least 30 minutes after administering medications before connecting the NG tube to suction to ensure the medication is absorbed adequately.