Multi-patient: Postop Transurethral Prostate Resection

1. What priority focused assessment data, taking the patients’ age into consideration, will you note upon initial assessment of the multi-patient scenario? Identify three pharmacological and three non-pharmacological interventions that would be appropriate for this scenario?
   1. Priority (one or two items) Assessment Data:
   2. Non-pharmacological:
   3. Pharmacological:
2. List the PMH that apply to this hospitalization. Explain how each affect this hospitalization.
3. List 3 potential complications for continuous bladder irrigation and two interventions for each?
4. What is the reason for admission and history of current illness?
   1. Reason:
   2. History:
5. All three patients were diagnosed with BPH, ultimately leading to the need for surgery. Describe what the medical diagnosis of BPH encompasses. Describe the procedure performed for a transurethral resection of the prostate (TURP) and list post-operative nursing care for it.
   1. BPH:
   2. TURP:
   3. Post-operative Nursing Care:

Post-op Complication #1:

Intervention:

Intervention:

Post-op Complication #2:

Intervention:

Intervention:

Post-op Complication #3:

Intervention:

Intervention:

1. All three patients had a TURP completed on the same day. One complication to this procedure is transurethral resection syndrome (TUR or TURP syndrome).

1. What is TUR or TURP syndrome?

1. What are the signs and symptoms of TUR or TURP syndrome?
2. What changes in patient condition might you see if the patient had a postoperative GI bleed?
   1. Patient Condition:
   2. List at least one medication in the patient’s medication list that may affect the color and/or consistency of stool and explain your rationale?
   3. What foods, if eaten, may affect the color of the patient’s stool?
3. What changes in patient condition, including labs and vital signs, might you see with stable angina?
   1. Labs:
   2. Vital Signs:
   3. Patient Presentation:
   4. What would be one priority action if you suspected a patient had stable angina?
4. What changes in patient condition, including labs and vital signs, might you see with unstable angina?
   1. Labs:
   2. Vital Signs:
   3. Patient Presentation:
   4. What would be one priority action if you suspected a patient had unstable angina?
5. The patients in this scenario have nitroglycerine ordered PRN.

1. What does it mean to administer the medication sublingual?

1. How many minutes should be given between doses? How many doses can a patient take?

1. Minutes:

1. Doses:

1. What changes in patient condition would indicate the patient could benefit from nitroglycerine?

1. If the medication is swallowed, is it appropriate to administer another tablet immediately?

1. What should the nurse teach the patient about taking sublingual nitroglycerine tablets?

1. What is the priority action if the patient complains of a headache immediately after taking nitroglycerine? Provide a rationale.

1.  Fibromyalgia is a chronic musculoskeletal disorder characterized by:
   1. Pain resulting from joint and muscle inflammation
   2. Muscle pain in the skeletal muscles
   3. Neurologic pain the skeletal muscles
   4. Diffuse pain, fatigue, and tender points
2. A 22 year old underwent brain surgery to remove a tumor. Following surgery. The patient experienced a peptic ulcer. What type of ulcer is this ?
   1. Stress
   2. Neurogenic
   3. Trauma
   4. Neurologic
3. A patient had an external fixation device placed for a fractured right femur. Which of the following findings indicate the possibility of acute compartment syndrome? (select all that apply)
   1. Toes are cool to touch bilaterally
   2. Left toes are slightly edematous compared to right
   3. Diminished pedal pulse
   4. Pain is unrelieved
   5. Right toes will not move

How mitigation-adaptation co-benefits can be leveraged to increase resilience

Identify three risk factors that can lead to polypharmacy. Explain the rationale for why each listed item is a risk factor. Risk factors are different than adverse drug reactions. ADRs can be a result of polypharmacy, and is important, but ADRs are not a risk factor.

Which assessment finding would be increased in a patient with diabetes insipidus?

1. temperature
2. urine output
3. serum glucose
4. BP