A 70-year-old client returned from a transurethral resection of ...

[debasdf]

A 70-year-old client returned from a transurethral resection of the prostate 8 hours ago with a continuous bladder irrigation. The nurse reviews his laboratory results as follows:
 
  Sodium
  128 mEq/L
  Hemoglobin
  14 g/dL
  Hematocrit
  42
  Red blood cell count
  4.5
  What action by the nurse is the most appropriate?
  a.
  Consider starting a blood transfusion.
  b.
  Slow down the bladder irrigation if the urine is pink.
  c.
  Report the findings to the surgeon immediately.
  d.
  Take the vital signs every 15 minutes.

Question 2

A 25-year-old client has recently been diagnosed with testicular cancer and is scheduled for radiation therapy. Which intervention by the nurse is best?
 
  a. Ask the client about his support system of friends and relatives.
  b. Encourage the client to verbalize his fears about sexual performance.
  c. Explore with the client the possibility of sperm collection.
  d. Provide privacy to allow time for reflection about the treatment.

[Sierray]

Answer to Question 1

ANS: B
The serum sodium is decreased due to large-volume bladder irrigation (normal is 136 to 145 mEq/L). By slowing the irrigation, there will be less fluid overload and sodium dilution. The hemoglobin and hematocrit values are a low normal, with a slight decrease in the red blood cell count. Therefore, a blood transfusion or frequent vital signs should not be necessary. Immediate report to the surgeon is not necessary.

Answer to Question 2

ANS: C
Sperm collection is a viable option for a client diagnosed with testicular cancer and should be completed before radiation therapy, chemotherapy, or radical lymph node dissection. The other options would promote psychosocial support but are not the priority intervention.