Page 1294 - Saunders Comprehensive Review For NCLEX-RN

1. The procedure involves insertion of a scope into the
urethra to excise prostatic tissue.
2. Monitor for hemorrhage; bleeding is common
following TURP.
3. Postoperative continuous bladder irrigation (CBI) may
be prescribed, which prevents catheter obstruction
from clots.
4. Assess for signs of transurethral resection syndrome,
which include signs of cerebral edema and increased
intracranial pressure, such as increased blood
pressure, bradycardia, confusion, disorientation,
muscle twitching, visual disturbances, and nausea
and vomiting.
5. Antispasmodics may be prescribed for bladder spasm.
6. Instruct the client to monitor and report dribbling or
incontinence postoperatively and teach perineal
exercises.
7. Sterility is possible following the surgical procedure.
F. Suprapubic prostatectomy
1. Suprapubic prostatectomy is removal of the prostate
gland by an abdominal incision with a bladder
incision.

2. The client will have an abdominal dressing

that may drain copious amounts of urine, and the
abdominal dressing will need to be changed
frequently.
3. Severe hemorrhage is possible, and monitoring for
blood loss is an important nursing intervention.
4. Antispasmodics may be prescribed for bladder
spasms.
5. CBI is prescribed and carried out to maintain pink-
colored urine.
6. Sterility occurs with this procedure.
G. Retropubic prostatectomy
1. Retropubic prostatectomy is removal of the prostate
gland by a low abdominal incision without opening
the bladder.
2. Less bleeding occurs with this procedure compared
with the suprapubic procedure, and the client
experiences fewer bladder spasms.
3. Abdominal drainage is minimal.
4. CBI may be used.
5. Sterility occurs with this procedure.
H. Perineal prostatectomy
1. The prostate gland is removed through an incision
made between the scrotum and anus.
2. Minimal bleeding occurs with this procedure.

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