After a urinary diversion pancreatic transplant, the nurse must anticipate which order?
a. Continuous bladder irrigation
b. Intermittent insulin injections
c. Removal of the nasogastric tube as soon as the patient is alert
d. Daily hematocrit and hemoglobin levels.
A
An increased potential for urinary catheter occlusion exists for pancreas recipients who have undergone a urinary diversion procedure. The exocrine pancreatic enzymes make the urine more viscous, and they irritate the anastomosis site on the bladder, causing an increased risk of bleeding. Gentle aspiration techniques can be used to clear out the clots. Continuous bladder irrigation may be necessary to keep the catheter patent. A nasogastric tube is usually placed and remains for 24 to 48 hours after surgery. A continuous insulin drip may be used to rest the new graft and prevent hyperglycemia.
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