The nurse reviews a prescription for the client who needs continuous bladder irrigation after prostate surgery. Which should the nurse implement to facilitate bladder irrigation?
1. Label irrigation solution with for GU irrigation only.
2. Change irrigation tubing at least once every 12 hours.
3. Infuse irrigation solution at 100 ml/hr for clear urine.
4. Ensure that client has a triple-lumen urinary catheter.
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4. The nurse confirms that the client has a triple lumen urinary catheter before begin-ning the irrigation because if the client does not have a suitable urinary catheter, the nurse needs to collaborate with the provider. Usually, when presented with a pre-scription to irrigate the bladder, the nurse implements necessary components of the procedure, including inserting a suitable urinary catheter; however, this client is postoperative from prostate surgery and manipulation of the urinary catheter poten-tially results in trauma to the operative site.
1. The nurse labels the irrigation solution properly according to agency policy for client safety and to prevent inadvertent intravenous infusion.
2. The nurse changes irrigation tubing according to agency policy, but every 12 hours is excessive and it is likely to contribute to an infection.
3. The nurse titrates the irrigation solution to maintain clear urine; the rate usually exceeds 100 ml/hr.
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