A 44-year-old patient is unable to void after having an open loop ...

[jerry coleman]

A 44-year-old patient is unable to void after having an open loop resection and fulguration of the bladder. Which nursing action should be implemented first?
 
  a. Assist the patient to soak in a 15-minute sitz bath.
  b. Insert a straight urethral catheter and drain the bladder.
  c. Encourage the patient to drink several glasses of water.
  d. Teach the patient how to do isometric perineal exercises.

Question 2

Which assessment finding is most important to report to the health care provider regarding a patient who has had left-sided extracorporeal shock wave lithotripsy?
 
  a. Blood in urine
  b. Left flank bruising
  c. Left flank discomfort
  d. Decreased urine output

[AngeliqueG]

Answer to Question 1

ANS: A
Sitz baths will relax the perineal muscles and promote voiding. Although the patient should be encouraged to drink fluids and Kegel exercises are helpful in the prevention of incontinence, these activities would not be helpful for a patient experiencing retention. Catheter insertion increases the risk for urinary tract infection (UTI) and should be avoided when possible

Answer to Question 2

ANS: D
Because lithotripsy breaks the stone into small sand, which could cause obstruction, it is important to report a drop in urine output. Left flank pain, bruising, and hematuria are common after lithotripsy.