A 70-year-old client returned from a transurethral resection of the prostate 8 hours ago with a continuous bladder irrigation. The nurse reviews his laboratory results as follows:
Sodium
128 mEq/L
Hemoglobin
14 g/dL
Hematocrit
42%
Red blood cell count
4.5
What action by the nurse is the most appropriate?
a.
Consider starting a blood transfusion.
b.
Slow down the bladder irrigation if the urine is pink.
c.
Report the findings to the surgeon immediately.
d.
Take the vital signs every 15 minutes.
ANS: B
The serum sodium is decreased due to large-volume bladder irrigation (normal is 136 to 145 mEq/L). By slowing the irrigation, there will be less fluid overload and sodium dilution. The hemoglobin and hematocrit values are a low normal, with a slight decrease in the red blood cell count. Therefore, a blood transfusion or frequent vital signs should not be necessary. Immediate report to the surgeon is not necessary.
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