Mr. Roberto was readmitted to the hospital with acute graft rejection. Which of the following assessment finding would be expected?
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Solution
Elevated BUN and Creatinine.
Steroids, if used following kidney transplantation would cause which of the following side effects?
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Solution
Increased Blood Glucose Level.
If a client’s prostate enlargement is caused by a malignancy, which of the following blood examinations should the nurse anticipate to assess whether metastasis has occurred?
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Solution
Serum acid phosphatase level
The most specific examination to determine whether a malignancy extends outside of the prostatic capsule is a study of the serum acid phosphatase level. The level increases when a malignancy has metastasized. The prostate-specific antigen (PSA) determination and a digital rectal examination are done when screening for prostate cancer. Serum creatinine level, total nonprotein nitrogen level, and endogenous creatinine clearance time give information about kidney function, not
Options A, C, and D: Serum creatinine level, total nonprotein nitrogen level, and endogenous creatinine clearance time give information about kidney function, not prostate malignancy.
A priority nursing diagnosis for the client who is being discharged t home 3 days after a TURP would be:
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Solution
Deficient fluid volume
Deficient Fluid Volume is a priority diagnosis because the client needs to drink a large amount of fluid to keep the urine clear. The urine should be almost without color. About two (2) weeks after a TURP, when desiccated tissue is sloughed out, a secondary hemorrhage could occur. The client should be instructed to call the surgeon or go to the ED if at any time the urine turns bright red.
Option B: The client is not specifically at risk for nutritional problems after a TURP. The client is not specifically at risk for nutritional problems after a TURP.
Option C: The client is not specifically at risk for impaired tissue integrity because there is no external incision.
Option D: The client is not specifically at risk for airway problems because the procedure is done after spinal anesthesia.
A client underwent a TURP, and a large three-way catheter was inserted into the bladder with continuous bladder irrigation. In which of the following circumstances would the nurse increase the flow rate of the continuous bladder irrigation?
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Solution
When the drainage becomes bright red
The decision made by the surgeon to insert a catheter after a TURP or prostatectomy depends on the amount of bleeding that is expected after the procedure. During continuous bladder irrigation after a TURP or prostatectomy, the rate at which the solution enters the bladder should be increased when the drainage becomes brighter red. The color indicates the presence of blood. Increasing the flow of irrigating solution helps flush the catheter well so clots do not plug it.
Option B: There would be no reason to increase the flow rate when the return is continuous or when the return appears cloudy and dark yellow.
Option D: Increasing the flow would be contraindicated when there is no return of urine and irrigating solution.
A client with BPH is being treated with terazosin (Hytrin) 2 mg at bedtime. The nurse should monitor the client’s:
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Solution
Blood pressure
Terazosin (Hytrin) is an antihypertensive drug that is also used in the treatment of BPH. Blood pressure must be monitored to ensure that the client does not develop hypotension, syncope, or postural hypotension. The client should be instructed to change positions slowly.
Options A, B, and D: Urinary nitrites, white blood cell count, and pulse rate are not affected by terazosin.
A client is scheduled to undergo a transurethral resection of the prostate gland (TURP). The procedure is to be done under spinal anesthesia. Postoperatively, the nurse should be particularly alert for early signs of:
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Solution
Respiratory paralysis
If paralysis of vasomotor nerves in the upper spinal cord occurs when spinal anesthesia is used, the client is likely to develop respiratory paralysis. Artificial ventilation is required until the effects of the anesthesia subside.
Options A, B, and C: Convulsions, cardiac arrest, and renal shutdown are not likely results of spinal anesthesia.
The nurse is reviewing a medication history of a client with BPH. Which medication should be recognized as likely to aggravate BPH?
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Solution
Inhaled ipratropium (Atrovent)
Atrovent is a bronchodilator, and its anticholinergic effects can aggravate urinary retention.
Options A and B: Glucophage and BuSpar do not affect the urinary system.
Option D: Timolol does not have a systemic effect.
The primary function of the prostate gland is:
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Solution
To produce a secretion that aids in the nourishment and passage of sperm
The prostate gland is located below the bladder and surrounds the urethra. It serves one primary purpose: to produce a secretion that aids in the nourishment and passage of sperm.
The primary reason for taping an indwelling catheter laterally to the thigh of a male client is to:
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Solution
Eliminate pressure at the penoscrotal angle
The primary reason for taping an indwelling catheter to a male client soothe penis is held in a lateral position to prevent pressure at the penoscrotal angle. Prolonged pressure at the penoscrotal angle can cause a ureterocutaneous fistula.