Question

While assessing a client three hours after a transurethral prostatectomy, the nurse notes that the catheter drainage is bright red in color and contains many chots. The nurse should give priority to: A. Continuing to monitor the drainage B. Immediately notifying the charge nurse C. Making sure that the catheter is taped snugly to the client's thigh D. Offering additional oral fluids to prevent dehydration

Short answer

Answer: B. Immediately notify the charge nurse.

Step-by-step solution

Assess the situation

Since the catheter drainage is bright red and contains many clots, it indicates that there might be some complications or issues post-surgery that need to be addressed urgently.

Evaluate each option

A. Continuing to monitor the drainage might not be the best choice because it requires immediate action, rather than just observation. B. Immediately notifying the charge nurse may be the best option, as it will allow necessary action to be taken by the appropriate staff member. C. Making sure that the catheter is taped snugly to the client's thigh does not address the issue of the bright red drainage and large number of clots. D. Offering additional oral fluids to prevent dehydration might be important for overall care, but it is not the priority in this situation as it does not address the immediate issue of the bright red drainage and presence of clots.

Choose the best option

After evaluating each option, we can conclude that the best option is: B. Immediately notifying the charge nurse, as it addresses the immediate issue in the most appropriate way and involves the appropriate staff member in the decision-making process.

Key concepts

Postoperative Nursing Care

A critical component after a transurethral prostatectomy—or any surgical procedure—is the postoperative nursing care. This period is crucial for monitoring the patient's recovery and rapidly identifying complications. Swift response to abnormal findings, such as the presence of bright red drainage in catheter output, could be the difference between a smooth recovery and a significant health concern.

During the immediate postoperative phase, healthcare professionals must also ensure that the patient's pain is managed, vitals are stable, and that the patient is meeting recovery milestones such as ambulating as appropriate. Monitoring for signs of bleeding, infection, or other complications is vital. The nurse's role includes observing changes in the characteristics of drainage, vital signs, and the overall wellbeing of the patient. Effective communication among the healthcare team is key. As seen in the textbook exercise, where the most appropriate action was to notify the charge nurse, such a decision underscores the importance of teamwork in managing the patient’s condition promptly. Timely intervention can greatly influence patient outcomes, making postoperative care a substantive area of focus in nursing education and practice.

Catheter Drainage Assessment

Assessing catheter drainage is an indispensable skill for nurses, especially following surgeries such as transurethral prostatectomy. The color, amount, and presence of clots can provide essential information on the patient's condition.

Normal catheter drainage following prostate surgery may be pink or slightly red, indicating that some bleeding is expected. However, bright red drainage with clots, as depicted in the textbook exercise, is a warning sign. It may indicate active bleeding, which warrants urgent attention. Nurses should be trained to assess the drainage quickly and equipped to take immediate action when necessary. Additionally, they should ensure the catheter is not kinked or blocked, as this could exacerbate the problem.

The assessment of catheter drainage is not only a technical skill but also a decision-making process. Nurses should integrate their observations with knowledge of the patient's history and the potential postoperative complications to make appropriate clinical judgments—therefore reinforcing the critical nature of this skill for patient safety and recovery.

NCLEX-PN Exam Preparation

Preparing for the NCLEX-PN exam is an essential step for practical nurses aiming to provide the best possible care to their patients. The exam tests knowledge and practical application across a wide array of topics, including postoperative care and acute complications like those associated with transurethral prostatectomy.

Nursing students should deeply understand complications, like the significance of the color of catheter drainage, and interventions, such as notifying charge nurses or physicians when findings suggest a complication. Preparing for these scenarios in the NCLEX-PN exam typically involves studying textbooks, solving practical case scenarios, and answering many practice questions. Strategies for effective preparation often include time management, understanding the format of the exam, developing critical thinking skills, and focusing on areas of weakness. Utilizing resources such as nursing care manuals, NCLEX-PN prep courses, and practice tests can help provide the comprehensive knowledge required to succeed on the exam.

Ultimately, thorough preparation for the NCLEX-PN not only facilitates passing the exam but also instills the confidence and competence needed to handle real-world nursing challenges effectively.