A nurse is caring for a postoperative client following a perineal prostatectomy. Exhibits For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

1. Apply warm compresses to the incision site Contraindicated Applying warm compresses directly to the surgical site, especially in a perineal prostatectomy, could potentially increase the risk of infection or cause increased swelling in the surgical area. The incision site is still healing, and local heat could increase blood flow, which might lead to complications like bleeding or infection. 2. Administer enema to relieve constipation Anticipated The client reports abdominal cramping and small, hard, painful bowel movements, which are signs of constipation. Enemas are commonly used to relieve constipation and to prevent straining that could stress the perineal surgical site or cause hemorrhoidal irritation. The use of an enema is appropriate in this case to help alleviate the client's symptoms. 3. Irrigate indwelling urinary catheter with 50 mL of normal saline Anticipated After prostatectomy, clients often have an indwelling urinary catheter for urinary drainage. Irrigating the catheter can help prevent clogging and maintain proper drainage. Normal saline is a sterile solution and would help ensure the catheter is patent, which is particularly important for preventing urinary retention or infection. 4. Place a blanket roll under the client's knees while in bed Anticipated Placing a blanket roll under the client’s knees helps to maintain a comfortable position, which can promote venous return and reduce pressure on the perineum and lower back. This position is also beneficial for alleviating perineal pain after prostate surgery. 5. Maintain bed rest for 2 days postoperatively Contraindicated The client has already demonstrated the ability to ambulate independently and transfer out of bed to a chair. Prolonged bed rest after surgery is generally discouraged unless there are specific complications (e.g., excessive bleeding, infection). Early ambulation is encouraged to prevent DVT, promote circulation, and prevent complications such as atelectasis and constipation.