Page 1295 - Saunders Comprehensive Review For NCLEX-RN

3. The client needs to be monitored closely for infection,
because the risk of infection is increased with this
type of prostatectomy.
4. Urinary incontinence is common.
5. The procedure causes sterility.
6. Teach the client how to perform perineal exercises.

I. Postoperative interventions

1. Monitor vital signs.
2. Monitor urinary output and urine for hemorrhage or
clots.
3. Increase fluids to 2400 to 3000 mL/day, unless
contraindicated.
4. Monitor for arterial bleeding as evidenced by bright
red urine with numerous clots; if it occurs, increase
CBI and notify the surgeon immediately.
5. Monitor for venous bleeding as evidenced by
burgundy-colored urine output; if it occurs, inform
the surgeon, who may apply traction on the catheter.
6. Monitor hemoglobin and hematocrit levels.
7. Expect red to light pink urine for 24 hours, turning to
amber in 3 days.
8. Ambulate the client as early as possible and as soon as
urine begins to clear in color.
9. Inform the client that a continuous feeling of an urge
to void is normal.
10. Instruct the client to avoid attempts to void around the
catheter, because this will cause bladder spasms.
11. Administer antibiotics, analgesics, stool softeners, and
antispasmodics as prescribed.
12. Monitor the 3-way urinary catheter, which usually has
a 30- to 45-mL retention balloon.
13. Maintain CBI with sterile bladder irrigation solution as
prescribed to keep the catheter free of obstruction and
keep the urine pink in color (Box 44-17).

Following TURP, monitor for transurethral resection syndrome

or severe hyponatremia (water intoxication) caused by the excessive
absorption of bladder irrigation during surgery. (Signs include altered
mental status, bradycardia, increased blood pressure, and confusion.)

J. Postoperative interventions: Suprapubic prostatectomy

1. Monitor suprapubic and urinary catheter drainage.
2. Monitor CBI if prescribed.
3. Note that the urinary catheter will be removed 2 to 4
days postoperatively if the client has a suprapubic

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