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    Ati rn comprehensive predictor 2023 retake proctored exam

    A nurse is assessing a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate 4 hr ago. The nurse notes pink-tinged urine in the drainage bag. Which of the following actions should the nurse take?

    Explanation & Rationale

    Rationale: A. Perform the Credé’s maneuver: This manual technique is used to assist bladder emptying in clients with urinary retention due to neurogenic bladder. It is not appropriate or necessary when continuous bladder irrigation is in place and the catheter is draining. B. Maintain the irrigation solution rate: Pink-tinged urine is expected during the early postoperative period following TURP, indicating mild bleeding. There is no need to adjust the irrigation rate unless there are signs of obstruction or bright red bleeding with clots. C. Replace the indwelling urinary catheter: Catheter replacement is only necessary if there is a blockage or malfunction. In this case, the system appears to be functioning correctly, and there’s no indication of obstruction. D. Warm the irrigation solution: Warming the irrigation fluid is not required and does not affect hematuria. The solution should be at room temperature unless otherwise prescribed. Hematuria at this stage is managed by monitoring, not fluid temperature changes.

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